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重型颅脑损伤管理指南。第1部分。神经创伤系统与神经影像学。

Guidelines for the management of severe head injury. Part 1. Neurotrauma system and neuroimaging.

作者信息

Potapov A A, Krylov V V, Gavrilov A G, Kravchuk A D, Likhterman L B, Petrikov S S, Talypov A E, Zakharova N E, Oshorov A V, Solodov A A

机构信息

Burdenko Neurosurgical Institute, Moscow, Russia.

Sklifosovsky Research Institute for Emergency Medicine, Moscow.

出版信息

Zh Vopr Neirokhir Im N N Burdenko. 2015;79(6):100-106. doi: 10.17116/neiro2015796100-106.

Abstract

Traumatic brain injury is one of the main causes of mortality and disability in young and middle-aged individuals. The patients with severe traumatic brain injury who are in coma are the most difficult to deal with. Appropriate diagnosis of the primary brain injuries and early prevention and treatment of secondary damage mechanisms largely determine the possibility of reducing mortality and severe disabling consequences. The authors compiled these guidelines based on their experience in development of international and Russian recommendations on the diagnosis and treatment of mild traumatic brain injury, penetrating gunshot injury of the skull and brain, severe traumatic brain injury, and severe consequences of brain injuries, including a vegetative state. In addition, we used the materials of international and Russian recommendations on the diagnosis, intensive care, and surgical treatment of severe traumatic brain injury published in recent years. The proposed recommendations are related to organization of medical care and diagnosis of severe traumatic brain injury in adults and are primarily addressed to neurosurgeons, neurologists, neuroradiologists, anesthesiologists, and emergency room doctors, who are routinely involved in management of these patients.

摘要

创伤性脑损伤是中青年人群死亡和残疾的主要原因之一。昏迷的重度创伤性脑损伤患者是最难处理的。对原发性脑损伤进行恰当诊断并对继发性损伤机制进行早期预防和治疗,在很大程度上决定了降低死亡率和严重致残后果的可能性。作者们基于其在制定关于轻度创伤性脑损伤、颅骨和脑穿透性枪伤、重度创伤性脑损伤以及脑损伤严重后果(包括植物状态)的国际和俄罗斯诊断与治疗建议方面的经验编写了本指南。此外,我们还采用了近年来发表的关于重度创伤性脑损伤诊断、重症监护和外科治疗的国际和俄罗斯建议材料。所提出的建议涉及成人重度创伤性脑损伤的医疗护理组织和诊断,主要面向神经外科医生、神经内科医生、神经放射科医生、麻醉医生以及急诊室医生,他们日常参与这些患者的管理工作。

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