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埃及急诊多发伤患者中与颌面骨折相关的脑损伤模式及其转归

Patterns of brain injuries associated with maxillofacial fractures and its fate in emergency Egyptian polytrauma patients.

作者信息

Elbaih Adel Hamed, El-Sayed Doaa A, Abou-Zeid Ahmed E, Elhadary Ghada K

机构信息

Department of Emergency Medicine, Faculty of Medicine, Suez Canal University, Ismailia, Egypt.

Department of Emergency Medicine, Faculty of Medicine, Suez Canal University, Ismailia, Egypt.

出版信息

Chin J Traumatol. 2018 Oct;21(5):287-292. doi: 10.1016/j.cjtee.2017.12.005. Epub 2018 Sep 8.

Abstract

PURPOSE

Maxillofacial injuries are commonly encountered in the practice of emergency medicine. More than 50% of patients with these injuries have multisystem trauma that requires coordinated management between emergency physicians and surgical specialists in oral and maxillofacial surgery, otolaryngology, plastic surgery, ophthalmology, and trauma surgery. The aim of this study is to identify the patterns of brain injuries associated with maxillofacial trauma and its outcome.

METHODS

This descriptive study (cross-sectional) was carried out among 90 polytrauma patients with maxillofacial fractures attending the Emergency Department at Suez Canal university Hospital and fulfilling our inclusion and exclusion criteria.

RESULTS

This study demonstrates the relation between type of maxillofacial fracture and type of traumatic brain injuries in which the majority of patients with epidural hemorrhage presented with mid face fractures (60%), while the minority of them presented with upper and lower face fractures (20% for each of them). The majority of patients with subdural hemorrhage were associated with mid face fractures (75%), the majority of patients with brain contusions associated with mid face fractures (75%), and all of the patients presented by pneumocephalus were associated with mid face fractures (100%).

CONCLUSION

The results of this study confirm the value of quick diagnosis and early intervention, which is fundamental to prevent morbidity as well as mortality especially with regards to prevention of traumatic brain injury as even a short duration of hypoxia and edema will lead to significant permanent neurological deficits.

摘要

目的

颌面损伤在急诊医学实践中很常见。超过50%的此类损伤患者存在多系统创伤,这需要急诊医生与口腔颌面外科、耳鼻喉科、整形外科、眼科和创伤外科的外科专家进行协调管理。本研究的目的是确定与颌面创伤相关的脑损伤模式及其结果。

方法

本描述性(横断面)研究在苏伊士运河大学医院急诊科就诊的90例伴有颌面骨折的多发伤患者中进行,这些患者符合我们的纳入和排除标准。

结果

本研究表明了颌面骨折类型与创伤性脑损伤类型之间的关系,其中硬膜外出血患者大多表现为面中部骨折(60%),而表现为面部上、下骨折的患者较少(各占20%)。硬膜下出血患者大多与面中部骨折有关(75%),脑挫伤患者大多与面中部骨折有关(75%),所有出现气颅的患者均与面中部骨折有关(100%)。

结论

本研究结果证实了快速诊断和早期干预的价值,这对于预防发病率和死亡率至关重要,尤其是在预防创伤性脑损伤方面,因为即使是短时间的缺氧和水肿也会导致严重的永久性神经功能缺损。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e731/6235787/aa3c1320ab47/gr1.jpg

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