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从超高海拔地区转运的创伤性脑损伤患者的临床特征及预后:病例系列研究

Clinical characteristics and outcomes of patients with traumatic brain injury transferred from ultra-high-altitude areas: patient series.

作者信息

Li Wenyan, Lan Chuan, Zheng Yi, Yin Yi, Tan Binbin, Xian Jishu, Hu Rong, Feng Hua, Chen Tunan, Li Fei

机构信息

Department of Neurosurgery, Southwest Hospital, Army Medical University, Chongqing, China.

出版信息

J Neurosurg Case Lessons. 2025 Aug 4;10(5). doi: 10.3171/CASE24823.

Abstract

BACKGROUND

Traumatic brain injury (TBI) patients transferred from high-altitude areas present with unique challenges that complicate the treatment of these patients. This study aims to summarize the clinical characteristics and treatment experience of TBI patients transferred to the authors' center from ultra-high-altitude areas.

OBSERVATIONS

The authors conducted a retrospective case series analysis of 10 TBI cases admitted to their center between January 2021 and December 2023. These patients were airlifted from areas > 3500 m above sea level. On admission and at specified intervals up to 30 days postadmission, patients underwent head CT scans, laboratory tests, and posttraumatic stress disorder (PTSD) assessments. Self-care ability scores and psychological assessments were obtained at various time points postdischarge. With a precise and proactive treatment strategy, there was a significant reduction in intracranial hematoma volume, hemoglobin levels, D-dimer, procalcitonin, and serum sodium by the 30th day. The incidence of PTSD was markedly reduced at 6 months postdischarge compared with initial assessments within the 1st week.

LESSONS

TBI patients transferred from high-altitude areas exhibited persistent intracerebral hematoma, elevated intracranial pressure, relative anemia, hypercoagulation, etc., and thus a precise and proactive treatment would benefit these patients. https://thejns.org/doi/10.3171/CASE24823.

摘要

背景

从高海拔地区转运来的创伤性脑损伤(TBI)患者面临着独特的挑战,这使这些患者的治疗变得复杂。本研究旨在总结从超高海拔地区转运至作者所在中心的TBI患者的临床特征及治疗经验。

观察结果

作者对2021年1月至2023年12月期间收治于其中心的10例TBI病例进行了回顾性病例系列分析。这些患者是从海拔>3500米的地区空运而来。入院时及入院后30天内的特定时间间隔,患者接受头部CT扫描、实验室检查及创伤后应激障碍(PTSD)评估。出院后不同时间点获取自理能力评分及心理评估结果。通过精确且积极的治疗策略,到第30天时颅内血肿体积、血红蛋白水平、D-二聚体、降钙素原及血清钠均显著降低。与出院后第1周内的初始评估相比,出院后6个月时PTSD的发生率明显降低。

经验教训

从高海拔地区转运来的TBI患者存在持续性脑内血肿、颅内压升高、相对性贫血、高凝状态等情况,因此精确且积极的治疗对这些患者有益。https://thejns.org/doi/10.3171/CASE24823

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e92a/12320725/c5eded3a08be/CASE24823_figure_1.jpg

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