Braun T, Kunz U, Schulz C, Lieber A, Willy C
Klinik für Unfall-, Hand- und Wiederherstellungschirurgie, Universitätsklinkum Giessen, Giessen, Deutschland.
Unfallchirurg. 2015 Aug;118(8):693-700. doi: 10.1007/s00113-013-2549-0.
Traumatic brain injury (TBI) is one of the most common causes of death in ordinary accidents, natural disasters, or warfare. The gold standard for diagnosis of TBI is the CT scan; a delay of diagnostics or medical care is the strongest independent predictor of mortality of TBI patients--particularly in the case of a surgically treatable intracranial hematoma. The proper classification of these patients is of major importance in situations where a CT is not accessible. A portable screening device that uses near-infrared spectroscopy (NIRS) technology allows a preliminary estimate of an intracranial hematoma. This study assessing practicability shows that the use of the device in a military medical rescue center (Kunduz, Afghanistan) is easy to learn and can be repeatedly used even under emergency room conditions. The technique can be applied in penetrating and blunt TBIs in the absence of an immediately available CT scan in rural areas, preclinically, under mass casualty conditions (e.g., in disaster situations) as well as in humanitarian crises or war zones. Nevertheless, further studies to assess the validity of this device are necessary.
创伤性脑损伤(TBI)是普通事故、自然灾害或战争中最常见的死亡原因之一。TBI诊断的金标准是CT扫描;诊断或医疗护理的延迟是TBI患者死亡率最强的独立预测因素——尤其是在可手术治疗的颅内血肿情况下。在无法进行CT检查的情况下,对这些患者进行正确分类至关重要。一种使用近红外光谱(NIRS)技术的便携式筛查设备可以对颅内血肿进行初步评估。这项评估实用性的研究表明,在军事医疗救援中心(阿富汗昆都士)使用该设备很容易掌握,即使在急诊室条件下也可重复使用。在农村地区、临床前、大规模伤亡情况下(如灾难情况)以及人道主义危机或战区,在没有即时可用CT扫描的情况下,该技术可应用于穿透性和钝性TBI。然而,有必要进行进一步研究以评估该设备的有效性。