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运动相关脑震荡的临床特征与早期检测

Clinical features and early detection of sport-related concussion.

作者信息

Ochiai Hidenobu, Abe Tomohiro

机构信息

Department of Traumatology and Critical Care Medicine Faculty of Medicine University of Miyazaki Miyazaki Japan.

出版信息

Acute Med Surg. 2018 Nov 8;6(1):49-53. doi: 10.1002/ams2.376. eCollection 2019 Jan.

Abstract

AIM

Athletes who suffer sport-related concussions but continue playing have a high probability of experiencing more severe symptoms with any subsequent concussion. This study used data from the authors' clinical department to retrospectively investigate the clinical characteristics of sport-related concussion and factors associated with delays in examinations.

METHODS

The study included 38 patients with sport-related concussions who were treated at the authors' hospital. The sports during which the injuries occurred, occasions of injury, factors affecting the time from injury until examination at hospital, and prognoses were evaluated retrospectively.

RESULTS

Sport-related concussions most frequently occurred in rugby and judo, where tackling, throwing, and other types of physical contact can result in impacts to the head region at high angular or linear velocity with acceleration. Some subjects showed consciousness disturbance and/or clear subjective symptoms immediately after the injury and were therefore examined at the hospital rapidly. However, other subjects who suffered amnesia or less obvious symptoms continued to play after the injury and had delayed examinations. In addition, there was a tendency for examinations to be delayed when an on-site physician was present.

CONCLUSIONS

In contact sports where injury-resulting events occur, such as impacts to the head at high angular or linear velocity with acceleration, athletes should be immediately withdrawn from play and evaluated for concussion, even if there are no obvious head injuries or symptoms. The immediate ascertainment of symptoms after physical contact would improve the rapid detection of sport-related concussion.

摘要

目的

遭受与运动相关脑震荡但仍继续比赛的运动员,在随后再次发生脑震荡时更有可能出现更严重的症状。本研究利用作者所在临床科室的数据,回顾性调查与运动相关脑震荡的临床特征以及与检查延迟相关的因素。

方法

本研究纳入了在作者所在医院接受治疗的38例与运动相关脑震荡患者。对受伤时所从事的运动、受伤场合、影响从受伤到医院就诊时间的因素以及预后进行了回顾性评估。

结果

与运动相关的脑震荡最常发生在橄榄球和柔道运动中,在这些运动中,擒抱、投掷和其他类型的身体接触会导致头部区域以高角加速度或线加速度受到撞击。一些受试者在受伤后立即出现意识障碍和/或明显的主观症状,因此迅速到医院就诊。然而,其他出现失忆或症状不太明显的受试者在受伤后继续比赛,检查延迟。此外,当有现场医生在场时,检查有延迟的倾向。

结论

在发生导致受伤事件的接触性运动中,如头部以高角加速度或线加速度受到撞击,即使没有明显的头部损伤或症状,运动员也应立即停止比赛并接受脑震荡评估。身体接触后立即确定症状将有助于快速检测与运动相关的脑震荡。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8f0b/6328848/85e85bc1a70f/AMS2-6-49-g001.jpg

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