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青少年运动员脑震荡的评估与管理

Evaluation and Management of Concussion in Young Athletes.

作者信息

Kosoy Jennifer, Feinstein Ronald

机构信息

Division of Adolescent Medicine, Cohen Children's Medical Center, Northwell Health, 410 Lakeville Road, Suite 108, New Hyde Park, New York 11042, United States; Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, United States.

出版信息

Curr Probl Pediatr Adolesc Health Care. 2018 May;48(5-6):139-150. doi: 10.1016/j.cppeds.2018.06.002. Epub 2018 Jul 14.

Abstract

Learning about concussion diagnosis and management is important for all individuals who will be taking care of young athletes. There are about 1.7million reported concussions per year, and, of these, about 20% are sports related. There are risks in all sports, but the highest rates of concussions are from football, rugby, and hockey, with soccer being the highest cause for girls. An on-field assessment includes evaluating airway, breathing, and circulation, followed by cervical spine assessment. Then, concussion evaluation tools can be used to aid in making the diagnosis. While concussion symptoms for the majority of youth resolve within a few weeks, some individuals may have persistence of symptoms for 3 months or more, referred to as postconcussive syndrome. Providers should consider ongoing symptoms in assessing when an athlete may safely return to sports and to learning. A major concern that has become more apparent in recent years is the possibility that concussions may have a longitudinal effect on health, such as in the development of chronic traumatic encephalopathy. Research has shown that there is an increase in the number of patients presenting to their primary care physician with concussions. Knowing how best to prevent, diagnose, and manage concussions will help to minimize risks to young athletes.

摘要

对于所有照顾年轻运动员的人来说,了解脑震荡的诊断和管理非常重要。每年报告的脑震荡病例约有170万例,其中约20%与运动有关。所有运动都存在风险,但脑震荡发生率最高的是美式橄榄球、英式橄榄球和曲棍球,而足球是女孩脑震荡的最主要原因。现场评估包括评估气道、呼吸和循环,随后进行颈椎评估。然后,可以使用脑震荡评估工具来辅助诊断。虽然大多数青少年的脑震荡症状会在几周内消失,但有些人的症状可能会持续3个月或更长时间,这被称为脑震荡后综合征。在评估运动员何时可以安全重返运动和学习时,医疗服务提供者应考虑持续存在的症状。近年来,一个越来越明显的主要担忧是,脑震荡可能会对健康产生长期影响,比如在慢性创伤性脑病的发展过程中。研究表明,因脑震荡前往初级保健医生处就诊的患者数量有所增加。了解如何最好地预防、诊断和管理脑震荡将有助于最大限度地降低年轻运动员面临的风险。

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