切换至 "中华医学电子期刊资源库"

中华诊断学电子杂志 ›› 2016, Vol. 04 ›› Issue (01) : 13 -18. doi: 10.3877/cma.j.issn.2095-655X.2016.01.005

所属专题: 文献

爆炸冲击伤诊治研究

爆炸冲击致失能性脑损伤的诊治原则与思考
高洁1, 王永堂1, 刘媛1, 王莉1, 伍亚民1, 赖西南1, 蒋建新1, 杨策1,()   
  1. 1. 400042 重庆,第三军医大学大坪医院野战外科研究所 创伤烧伤与复合伤国家重点实验室
  • 收稿日期:2015-12-16 出版日期:2016-02-26
  • 通信作者: 杨策
  • 基金资助:
    全军"十二五"项目(15QNP063); 全军"十二五"重大项目(AWS11J008,AWS14C003); 国家"973"课题(2012CB518102)

The diagnostic and therapeutic principle of explosive blast induced disabling brain injury and its thinking

Jie Gao1, Yongtang Wang1, Yuan Liu1, Li Wang1, Yamin Wu1, Xinan Lai1, Jianxin Jiang1, Ce Yang1,()   

  1. 1. State Key Laboratory of Trauma, Burns and Combined Injury, Institute of Surgery Research, Daping Hospital, Third Military Medical University, Changjiang Zhilu, Daping, Chongqing 400042, China
  • Received:2015-12-16 Published:2016-02-26
  • Corresponding author: Ce Yang
  • About author:
    Corresponding author: Yang Ce, Email:
引用本文:

高洁, 王永堂, 刘媛, 王莉, 伍亚民, 赖西南, 蒋建新, 杨策. 爆炸冲击致失能性脑损伤的诊治原则与思考[J/OL]. 中华诊断学电子杂志, 2016, 04(01): 13-18.

Jie Gao, Yongtang Wang, Yuan Liu, Li Wang, Yamin Wu, Xinan Lai, Jianxin Jiang, Ce Yang. The diagnostic and therapeutic principle of explosive blast induced disabling brain injury and its thinking[J/OL]. Chinese Journal of Diagnostics(Electronic Edition), 2016, 04(01): 13-18.

爆炸事件越来越频繁,以无临床指征和影像学表现为特点的失能性脑损伤患者是主要群体,但一直缺乏关注。笔者基于轻度创伤性脑损伤、创伤后应激障碍、慢性创伤性脑病,系统回顾了国内外关于失能性脑损伤的伤情特点、诊断、措施以及特殊环境下爆炸伤的救治难点和最新诊治前景。强调早诊治、早防护以及及时地心理干预,为诊治和防护爆炸冲击伤后亲历者的脑损伤提供有益启示。

The explosive accidents happened frequently.Patients with disabling brain injury constitute the main population which is paid little attention.Based on the current researches about mild traumatic brain injury, post traumatic stress disorder (PTSD) and chronic traumatic encephalopathy, the blast mechanism, pathophysiology, diagnosis, medical treatment, difficulties and the future progress are systematically reviewed.The early diagnosis, early prevention and first-aid psychological intervention are emphasized for the brain health of the population suffering from exposure of explosive blast injury.

[1]
王正国. 外科学与野战外科学[M]. 北京: 人民军医出版社,2007: 688-699.
[2]
张连阳. 灾难爆炸伤救援进展[J]. 解放军医学, 2015, 40(9): 689-692.
[3]
高洁,康建毅,赖西南. 中枢神经系统冲击波损伤及救治原则[J]. 中华神经科学杂志, 2009, 8(11): 1184-1186.
[4]
Elsayed NM,Atkins JL.Explosion and blast-related injuries[M].1th ed.Elsevier (Singarpore) Pte Ltd,2010: 1-26.
[5]
Ono k,Kikuchi A,Nakamura M, et al.Human head tolerance to sagital impact reliable estimation deduced from experimental head injury using sub-human primates and human cadaver skulls[J]. Proceeding of 24 th stap car crash conf, 1980, 101-106.
[6]
杨志焕,周继红,康建毅, 等. 爆炸冲击波生物损伤效应评估[J]. 野战外科通讯, 2006, 31(3): 14-15.
[7]
Chou CY,La Marca R,Steptoe A, et al.Biological responses to trauma and the development of intrusive memories:an analog study with the trauma film paradigm[J]. Biol Psychol, 2014(103): 135-143.
[8]
Goldstein LE,Fisher AM,Tagge CA, et al.Chronic traumatic ence phalopathy in blast-exposed military veterans and a blast neurotrauma mouse model[J]. Sci Transl Med, 2012, 4(134): 134ra60.
[9]
杜加瑞,余果,颜玉峰, 等. 轻中度颅脑创伤患者早期症状群的分析研究[J]. 中国神经外科疾病研究杂志, 2014, 13(4): 332-336.
[10]
Alexander MP.Mild traumatic brain injury:pathphysiology, nautral hisoty, and clinical management[J]. Neurology, 1995, 45(7): 1253-1260.
[11]
Management of concussion/mTBI working Group.VA/Dod clinical practice guideline for management of concussion/mild traumatic brain injury[J]. J Rehabil Res Dev, 2009, 46(6): CP1-68.
[12]
Skobska O. The 11th symposium of the international neurotrauma society march 19-23, 2014 Budapest, Hungary[J]. J Neurotrauma, 2014(31): A-41.
[13]
American psychiatric association.Diagnostic and statistical manual of mental pisorders[M].5th ed.American Psychiatric Publishing,2013.
[14]
Kokjohn TA,Maarouf CL,Daugs ID, et al.Neurochemical Profile of Dementia Pugilistica[J]. J Neurotrauma, 2013, 30(11): 981-987.
[15]
Saing T,Dick M,Nelson PT, et al.Frontal Cortex Neuropathology in Dementia Pugilistica[J]. J Neurotrauma, 2012, 29(6): 1054-1070.
[16]
Goeller J,Wardlaw A,Treichler D, et al.Investigation of cavitation as a possible damage mechanism in blast-induced traumatic brain injury[J]. J neurotrauma, 2012, 29(10): 1970-1981.
[17]
Mouzon B,Chaytow H,Grynen G, et al.Repetitive Mild traumatic brain injury in a mouse model produces learning and memory deficits accompanied by histological changes[J]. J Neurotrauma, 2012, 29(18): 2761-2773.
[18]
Eakin K,Miller JP,Jneurotrauma, et al.Mild traumatic brain injury is associated with impaired hippocampal spatiotemporal representation in the absence of histological changes[J]. J Neurotrauma, 2012, 29(6): 1180-1187.
[19]
Baalman KL,Cotton RJ,Rasband SN, et al.Blast wave exposure impairs memory and decreases axon initial segment length[J]. J Neurotrauma, 2013, 30(9): 741-751.
[20]
Gao J,Wang H,Liu Y, et al.Glutamate and GABA imbalance promote neuronal apoptosis in hippocmpus after stress[J]. Med Sci Monit, 2014(20): 499-512.
[21]
Gao J,Chen C,Liu Y, et al.Lycium barbarum polysaccharide improves traumatic cognition via reversing imbalance of apoptosis/regeneration in hippocampal neurons after stress[J]. Life Sci, 2015(121): 124-134.
[22]
Elder GA,Dorr NP,De Gasperi R, et al.Blast exposure induces post-traumatic stress disorder-related traits in a rat model of mild traumatic brain injury[J]. J Neurotrauma, 2012, 29(16): 2564-2575.
[23]
王正国. 冲击伤创伤学基础与临床[M]. 武汉: 湖北科学技术出版社,2006: 1278-1280.
[24]
高洁,康健毅,王丽丽, 等. 密闭舱室内爆炸致大鼠失能性脑损伤的神经电生理机制研究[J]. 解放军医学杂志, 2015, 40(8): 666-670.
[25]
Luo Q,Xu D,Roskos T, et al.Complexity analysis of resting state magnetoencephalography activity in traumatic brain injury patients[J]. J Neurotrauma, 2013, 30(20): 1702-1709.
[26]
Miller DR,Hayes JP,Laflenche G, et al.White matter abnormalities are associated with chronic postconcussion symptoms in blast-related mild traumatic brain injury[J]. Hum Brain Mapp, 2015.
[27]
McCauley SR,Wilde EA,Barnes A, et al.Patterns of early emotional and neuropsychological sequelae after mild traumatic brain injury[J]. J Neurotrauma, 2014, 31(10): 914-925.
[28]
Thelin EP,Johannesson L,Nelson D, et al.S100B is an important outcome predictor in traumatic brain injury[J]. J Neurotrauma, 2013, 30(7): 519-528.
[29]
Harch PG.Hyperbaric oxygen therapy for post-concussion syndrome:contradictory conclusions from a study mischaracterized as sham-controlled[J]. J Neurotrauma, 2013, 30(23): 1995-1999.
[30]
Balakathiresan N,Bhomia M,Chandran R, et al.MicroRNA Let-7i is a promising serum biomarker for blast-induced traumatic brain injury[J]. J Neurotrauma, 2012, 29(7): 1379-1387.
[31]
Abstracts from the 11th symposium of the international neurotrauma society march 19-23, 2014Budapest, Hungary[J]. J Neutrauma, 2014, 31: A-73.
[32]
Hanley DF,Chabot R,Mould WA, et al.Use of brain electrical activity for the identification of hematomas in mild traumatic brain injury[J]. J Neurotrauma, 2013, 30(24): 2051-2056.
[33]
Rodgers KM,Bercum FM,McCallum DL, et al.Acute neuroimmune modulation attenuates the development of anxiety-like freezing behavior in an animal model of traumatic brain injury[J]. J Neurotrauma, 2012, 29(10): 1886-1897.
[34]
Luo Q,Xu D,Roskos T, et al.Complexity analysis of resting state magnetoencephalography activity in traumatic brain injury patients[J]. J Neurotrauma, 2013, 30(20): 1702-1709.
[35]
王庆松,谭庆荣. 创伤后应激障碍[M]. 北京: 人民卫生出版社,2015: 214-216.
[36]
Munivenkatappa A. The 11th symposium of the international neuro trauma societymarch 19-23, 2014 Budapest, Hungary[J]. J Neutotrauma, 2014(31): A-7.
[37]
Rockhill CM,Jaffe K,Zhou C, et al.Health care costs associated with traumatic brain injury and psychiatric illness in adults[J]. J Neurotrauma, 2012, 29(6): 1038-1046.
[1] 王亚红, 蔡胜, 葛志通, 杨筱, 李建初. 颅骨骨膜窦的超声表现一例[J/OL]. 中华医学超声杂志(电子版), 2024, 21(11): 1089-1091.
[2] 唐金侨, 叶宇佳, 王港, 赵彬, 马艳宁. 医学影像学检查方法在颞下颌关节紊乱病中临床应用研究进展[J/OL]. 中华口腔医学研究杂志(电子版), 2024, 18(06): 406-411.
[3] 屈翔宇, 张懿刚, 李浩令, 邱天, 谈燚. USP24及其共表达肿瘤代谢基因在肝细胞癌中的诊断和预后预测作用[J/OL]. 中华普外科手术学杂志(电子版), 2024, 18(06): 659-662.
[4] 赵林娟, 吕婕, 王文胜, 马德茂, 侯涛. 超声引导下染色剂标记切缘的梭柱型和圆柱型保乳区段切除术的效果研究[J/OL]. 中华普外科手术学杂志(电子版), 2024, 18(06): 634-637.
[5] 熊鹰, 林敬莱, 白奇, 郭剑明, 王烁. 肾癌自动化病理诊断:AI离临床还有多远?[J/OL]. 中华腔镜泌尿外科杂志(电子版), 2024, 18(06): 535-540.
[6] 王秋生. 胆道良性疾病诊疗策略[J/OL]. 中华肝脏外科手术学电子杂志, 2024, 13(06): 779-782.
[7] 中华医学会器官移植学分会. 肝移植术后缺血性胆道病变诊断与治疗中国实践指南[J/OL]. 中华肝脏外科手术学电子杂志, 2024, 13(06): 739-748.
[8] 郑大雯, 王健东. 胆囊癌辅助诊断研究进展[J/OL]. 中华肝脏外科手术学电子杂志, 2024, 13(06): 769-773.
[9] 袁雨涵, 杨盛力. 体液和组织蛋白质组学分析在肝癌早期分子诊断中的研究进展[J/OL]. 中华肝脏外科手术学电子杂志, 2024, 13(06): 883-888.
[10] 李浩, 陈棋帅, 费发珠, 张宁伟, 李元东, 王硕晨, 任宾. 慢性肝病肝纤维化无创诊断的研究进展[J/OL]. 中华临床医师杂志(电子版), 2024, 18(09): 863-867.
[11] 谭瑞义. 小细胞骨肉瘤诊断及治疗研究现状与进展[J/OL]. 中华临床医师杂志(电子版), 2024, 18(08): 781-784.
[12] 王子阳, 王宏宾, 刘晓旌. 血清标志物对甲胎蛋白阴性肝细胞癌诊断的研究进展[J/OL]. 中华临床医师杂志(电子版), 2024, 18(07): 677-681.
[13] 陈慧, 邹祖鹏, 周田田, 张艺丹, 张海萍. 皮肤镜对头皮红斑性皮肤病辅助鉴别诊断的研究进展[J/OL]. 中华临床医师杂志(电子版), 2024, 18(07): 692-698.
[14] 胡云鹤, 周玉焯, 付瑞瑛, 于凡, 李爱东. CHS-DRG付费制度下GB1分组住院费用影响因素分析与管理策略探讨[J/OL]. 中华临床医师杂志(电子版), 2024, 18(06): 568-574.
[15] 朱旦华, 卢放根. 以腹水为主要特征的Castleman病16例[J/OL]. 中华临床医师杂志(电子版), 2024, 18(05): 462-473.
阅读次数
全文


摘要


AI


AI小编
你好!我是《中华医学电子期刊资源库》AI小编,有什么可以帮您的吗?