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find Keyword "脑外伤" 18 results
  • 脑外伤合并截肢1例报道及康复体会

    目的:探讨早期康复介入对脑外伤重症患者疗效的影响;方法:对该重症脑外伤患者实施早期综合康复介入治疗;结果:患者肢体及认知功能得到极大的提高,出院时达到了安装假肢步行出院的目标;结论:早期康复介入治疗对改善重症脑外伤患者肢体及认知等各方面功能均有很大疗效,可使患者更高更好更快的回归社会。

    Release date:2016-09-08 09:54 Export PDF Favorites Scan
  • The clinical feature, prognosis and prognostic factors of early post-traumatic seizures in children

    ObjectiveTo investigate the clinical feature, prognosis and prognostic factors of early post-traumatic seizures in children. MethodsRetrospective review was performed on 101 individuals with early post-traumatic seizures (EPTS) who were diagnosed in Department of Neurosurgery in Children's Hospital of Chongqing Medical University from January 2008 to June 2013. The record was collected, which included patient's demographics, clinical and radiological presentation, management, and follow-up results of 12 months. The individuals were divided into late post-traumatic seizures (LPTS) group and control group according to the occurrence of LPTS or not. The SAS 9.2 was used for statistical analysis. ResultsDuring 101 cases in our study, male accounted for 60.4%, female accounted for 39.6%, and the ratio was 1.5 to 1. The percentage of patients who were under 6 years old was 74.3%, and the number of cases decreased with age. The peak time of EPTS was within 24 hours after traumatic brain injury. 55.4% of EPTS was the generalized seizures, 34.7% was the partial seizures, and 9.9% was the partial seizures and evolved to secondarily generalized seizures. The incidence of LPTS observed in our study was 26.7% within 12 months follow-up. The electroencephalogram displayed epileptiform discharges in 3 individuals who were without epileptic seizures. There was statistically significant difference in group LPTS compared to control group on these factors which included GSC score≤8(P=0.0064), complicated necrencephalus and/or encephalatrophy(P < 0.0001), multiple brain injuries(P=0.0210), subdural hemorrhage(P=0.0151) and intracranial operation(P=0.0029). The age, history, epileptic seizure type of EPTS, brain contusion, skull fracture and the early use of antiepileptic drugs (AEDs) had no statistically significant difference between LPTS group and control group(P > 0.05). ConclusionsEPTS is prone to occur in children under 6 years old. Male is obviously more than female, and the ratio is 1.5:1. The peak time of EPTS is within 24 hours after traumatic brain injury and most of EPTS are generalized seizures. The incidence of LPTS in children with EPTS exceeds those previously reported. Periodical electroencephalogram examination is essential to decrease the missed diagnosis of LPTS. The GSC score≤8 and complicated necrencephalus and/or encephalatrophy will dramaticlly increase the risk of LPTS. Multiple brain injuries, subdural hemorrhage and intracranial operation are also risk factors for the prognosis of EPTS. Although the use of AEDs is unable to decrease the incidence of LPTS after 12 months follow-up, it is probably beneficial to improving the cognition and brain development. The controversial finding in our study is whether intracranial operation can influence the prognosis of EPTS or not.

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  • 癫痫的一级预防:一项来自国际抗癫痫联盟预防工作组的报告

    目前导致癫痫的病因中,有些是可以预防的。该综述总结了由此类可预防病因所造成的癫痫的公共卫生负担,并提出了癫痫一级预防的重要性。系统性回顾针对癫痫的 4 种可预防病因的流行病学研究,这些可预防病因分别是围产期损伤、脑外伤、中枢神经系统感染和卒中。通过使用统一的标准,对每项研究进行质量评估,并从满足质量评级标准的研究中提取了相关风险度量的数据,并将这些结果以中位数和四分位数的方式汇总。高质量的基于人群的研究结果显示,在中低收入国家中,所有年龄段的癫痫患病率约为 1.11%,而在高收入国家中约为 0.7%。围产期脑损伤是儿童癫痫中最常见的可预防病因,在中低收入国家中占 17%,在高收入国家中占 15%。在中低收入和高收入国家中,卒中均是老年癫痫患者中最常见的可预防病因,占所有新发癫痫病例的半数及以上,在高收入和中低收入国家中约 5%癫痫是由卒中造成的。在中低收入国家,中枢神经系统感染是较常见的癫痫病因,约占所有癫痫病例的 5%。在一些低收入农村地区和中等收入国家社区中,地方性神经囊虫病所致癫痫占所有癫痫病例的 34%。可预防的病因所致癫痫占癫痫的总体公共卫生负担的很大一部分。在中低收入和高收入国家中,围产期损伤、感染、脑外伤和卒中所致癫痫占所有癫痫的 25%。母婴保健、免疫接种、公共卫生、预防脑损伤和卒中这些公共卫生干预措施有可能会显著减少癫痫负担。

    Release date:2020-01-09 08:49 Export PDF Favorites Scan
  • Clinical Significance of Dynamic Detection of Plasma P-selectin in the Patients with Traumatic Cerebral Infarction

    目的:研究外伤性脑梗死患者血小板P选择素动态变化的临床意义。方法:用流式细胞仪测定42例外伤性脑梗死患者,50例无脑梗死外伤患者及40例正常对照者外周血血小板P选择素。结果:急性期(1周内)外伤性脑梗死患者P选择素明显高于无梗死脑外伤患者和健康对照组(Plt;0.01)。14 d时,外伤性脑梗死患者血小板P选择素表达,与无梗死脑外伤患者和健康对照组无显著差异(Pgt;0.005)。结论:P选择素参与外伤性脑梗死的病理过程,测定它们有利于外伤性脑梗死的早期诊治,改善预后。

    Release date:2016-09-08 09:54 Export PDF Favorites Scan
  • The Feasibility and Advantages of an Integrated Department of Internal and Surgical Neurology

    目的 探讨二级医院神经内外科整合的可行性及优越性,观察组织化医疗模式的临床效果。 方法 将神经内、外科整合为一个一级临床科室——脑系科,建立完善的多学科一体化治疗的组织化医疗网络体系。入选重型颅脑外伤和脑出血患者共289例,其中2004年8月-2008年12月在脑系科住院的重型颅脑外伤、脑出血患者共147例接受组织化医疗模式治疗,作为治疗组;2001年1月-2004年8月分散在我院内科、外科住院的重型颅脑外伤、脑出血患者共142例接受传统常规治疗,作为对照组。比较观察两组患者的治疗效果。 结果 治疗组神经功能缺损评分、日常生活活动能力评分和GCS分别为7.47±5.24、59.74±15.56和13.72±1.06;对照组分别为16.18±9.89、34.00±10.54和10.84±1.58。两组比较,差异有统计学意义(Plt;0.05)。治疗组与对照组比较,临床治愈率提高55.64%,平均住院日缩短10.34 d,病死率降低21.26%,并发症降低20.15%,致残率降低20.24%。 结论 采用组织化医疗模式能明显改善患者预后,缩短住院时间,提高患者的生活质量,是适合我国基层医院神经内、外科危急重症的治疗模式,具有其可行性及优越性。

    Release date:2016-09-08 09:47 Export PDF Favorites Scan
  • Helmet Laws Reduce Head Injuries for Cyclists

    Release date:2016-09-07 02:15 Export PDF Favorites Scan
  • Research progress of correlation between traumatic brain injury and fracture healing

    Objective To review the current status and advances of the correlation between traumatic brain injury (TBI) and fracture healing. Methods The related domestic and abroad literature about the correlation between TBI and fracture healing was extensively reviewed and analyzed. Results There are a variety of studies on the correlation between TBI and fracture healing, which can be divided into two major aspects: revascularization and osteogenesis; the local and systemic changes of the neuropeptide and hormone after TBI. Conclusion TBI facilitates callus formation, the further research is needed to clarify the exact mechanism.

    Release date:2017-07-13 11:11 Export PDF Favorites Scan
  • The Difficulty in the Treatment and the Strategy of the Patients of Craniocerebral Injury Combined with Eye Injury in the Earthquake

    目的:分析地震灾害中颅脑外伤合并眼伤的临床特点和诊治难点,为制定合理的对策提供参考。方法:统计分析2008年5月12日汶川地震中绵阳地区颅脑外伤合并眼伤96例的疾病资料,以及早期处理方案和效果。结果:颅脑外伤合并的眼伤中钝挫伤比例高(99.5%),昏迷患者容易忽视眼部损伤。结论:在生命抢救后的功能抢救阶段及时检查眼部情况有利于早期发现和挽救视功能;根据灾情整合眼科医疗资源,利用原有团队建制,有利于提高医院对大规模灾情的紧急应对效率。

    Release date:2016-09-08 09:54 Export PDF Favorites Scan
  • Number Variation Trend of Inpatients with Traumatic Brain Injury in High Altitude and Plain Areas

    Objective To explore the number variation trend of inpatients with traumatic brain injury (TBI) in high altitude and plain areas. Methods The first page information in medical records of TBI patients, who were admitted to military hospitals from 2001 to 2007, was searched and extracted from the Chinese Trauma Database. Two military hospitals in high altitude area and another two in the same hospital level in plain area were selected. Then, the number variation trend of TBI inpatients in those two areas was compared. Results In high altitude area, the proportion of male patients and their median inpatient days were higher, while the age, proportion of Han patients and surgery rate were lower than those in plain area (all Plt;0.001). During 2001-2007, there were 9 141 TBI patients discharged from the four hospitals, and the average annual growth rate was 13.15%. In high altitude area, the average annual growth rate of discharged inpatients was 24.00%, while in plain area, it was just 7.09%. The 4 common categories of TBI were intracranial injury, open wound of the head, neck and trunk, skull fracture, and other injuries. Conclusion Compared with the plain area, there are significant differences in the demographics, hospital stay and surgery of inpatients in high altitude area. The average annual growth rate of TBI inpatients discharged from hospitals in high altitude area is faster than that in plain area, to which should be paid attention by relevant departments.

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  • EFFECT OF BRAIN INJURY ON EXPRESSION OF BONE MORPHOGENETIC PROTEIN 2 IN FRACTUREHEALING PROCESS

    Objective To investigate the changes in the expression level of bone morphogenetic protein 2 (BMP2) in the bone callus of rats with femoral fracture and brain injury to explore the effect of the brain injury on the fracture healing and to explore the related mechanism. Methods Thirty-two 12 week old SD rats weighing 368±25 g were randomly divided into 4 groups of 8 rats in each. The rats in Group A had a femoral fracture and a brain injury for 1 week; the rats in Group B had a femoral fracture but without brain injury for 1 week; the rats in Group C had a fracture and a brain injury for 2 weeks; and the rats in Group D had a fracture but without brain injury for 2 weeks. Thus, Groups A and C were used as the femoral fracture and brain injury models, and Groups B and D as the pure femoral fracture models for the controlled study. After the X-ray films were taken, the bone callus was obtained 1 week and 2 weeks after operation, respectively. Then, the bone callus growth and its histology were examined with theHE staining, the expression and changes in the level of BMP-2 were examined with the immunohistochemical staining, and the level of BMP-2 mRNA was measured with the RT-PCR. Results The X-ray films showed that less bone callus formation was found in Group A, and the fracture line in Group B was clearer than that in Group A. There was a greater amount of callus in Group C, and the fracture line was blurred. Only a little bone callus formation was found in Group D. The HE staining indicated that more fibroblasts and early-stage chondrocytes were found in Group A; some fibroblasts in the fracture interspace and fewer early-stage chondrocytes in Group B; some newly-formed trabecular bone at the end of the fracture in Group C; but no trabecular bone formation in Group D. The immunohistochemical staining indicated that the positive expression of BMP2 was b in the cytoplasms of the fibroblasts, the mesenchymal cells, the vascular endothelial cells, the early-stage chondrocytes, and the osteoblasts. The number of the positive cells was greater in Group A than in Group B, with a higher color intensity. The number of the positive cells was greater in Group C than in Group D, with a higher color intensity. The percentages of the cells positive for BMP-2 in the callus were greater in Groups A and C (0.762%±0.052%,0.756%±0.079%)than in Groups B and D (0.702%±0.052%,0.672%±0.044%) at the same time point, ith a statistically significant difference (Plt;0.05). The RT-PCR analysis showed that the expression of BMP-2 mRNA in the callus in Groups A-D was decreased in sequence. There was a significantly higher level of the expression in Groups A and C(1.07±0.13,0.78±0.11) than in Groups B and D(0.91±0.12,0.61±0.08) at the same time point (Plt;0.05). Conclusion The brain injury can promote the fracture healing process, which is probably related to an increase in the expression level of BMP-2 after the brain injury.

    Release date:2016-09-01 09:20 Export PDF Favorites Scan
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