中型颅脑损伤脑干听觉诱发电位（BAEP）的研究

目的：探讨中型颅脑损伤脑干听觉诱发电位（BAEP）的特点。方法：对14例中型颅脑损伤伤者进行BAEP检测和分级评估。结果：中型颅脑损伤伤者BAEP的异常率为85．7％，其中脑干段电反应异常率达71．4％；BAEP的分级以Ⅲ级为主。结论：中型颅脑损伤伤者存在脑干功能障碍。     

重度颅脑损伤患者鼻饲护理的研究进展

参考近五年国内相关文献后,结合本人几年临床护理经验对鼻饲护理的现状进行了简要介绍.由于鼻饲本身有创性的特点使得在临床上中存许多尚未解决的问题.国内近几年的研究也得出了一些解决方法.但解决方案有待进一步的研究和完善.     

重型颅脑损伤病人的呼吸道护理

重型颅脑损伤具有发病率高，病情复杂，变化迅速，并发症多，损伤难度大及死亡率高等特点。颅脑损伤后脑细胞脆弱，血氧不足将加重脑细胞损害，呼吸功能障碍是颅脑损伤最常见的死亡原因，加强呼吸道管理对脑保护是至关重要的。     

颅脑损伤病人的院前急救护理

颅脑损伤病人病情重,变化快.快速有效的院前抢救生命及院内救治及预后.现将我院 1999 年 12月～2001年6月 50例颅脑损伤病人的院前急救护理报告如下.     

颅脑损伤病人的院前急救护理

颅脑损伤病人病情重 ,变化快 .快速有效的院前抢救生命及院内救治及预后 .现将我院 1999年 12月～2 0 0 1年 6月 5 0例颅脑损伤病人的院前急救护理报告如下 .1　一般资料5 0例患者中 ,男 36例 ,女 14例 .年龄 12岁～ 86岁 ,平均 36岁 .车祸 4 0例 ,跌伤 8例 ,撞击 2例 .现场ＧＣＳ评分 >8分 ,38例 ,<8分 ,12例 .院前急救过程时间 2 0～ 60分钟 ,平均 38分 .路程 2 0公里以内 .5 0例病人经入院后确诊 ,颅内血肿 2 5例 ,颅底骨折 4例 ,颅内血肿并脑挫伤 16例 ,脑挫伤并颅底骨折 5例 .5 0例中合并休克者 5例 ,胸腹部损伤 3例 ,四肢骨折 7例 .2…     

颅脑损伤患者血浆NPY及CGRP检测的临床意义

目的探讨血浆神经肽Y（NPY）和降钙素基因相关肽（CGRP）水平在不同程度颅脑外伤患者中的临床意义。方法采用放射免疫方法（RIA）对91例依据GCS评分法分为轻度、中度和重度的颅脑损伤患者及35例正常对照组的NPY、CGRP和ET-1水平进行检测。结果轻、中、重三组颅脑损伤患者血浆NPY水平分别为（119.6±20.3）ng/L、（127.8±25.5）ng/L和（146.2±30.5）ng/L,显著高于正常对照组（65.2±13.2）ng/L,差异有统计学意义（P〈0.01）。轻、中度患者血浆CGRP含量分别为（54.3±5.6）ng/L、（57.5±7.4）ng/L,显著高于正常对照组（41.8±6.8）ng/L,差异有统计学意义（P〈0.01）;而重度患者组的CGRP水平（44.6±5.3）ng/L与对照组（41.8±6.8）ng/L间差异无统计学意义（P〉0.05）。结论血浆NPY及CGRP水平与不同程度颅脑损伤患者的病情密切相关,并对患者预后的判定具有一定的临床参考价值。     

酒后颅脑损伤患者的护理

酒后颅脑损伤病情较凶险且复杂,并发症较多。及时的救治、细致入微的护理及患者和家属的积极配合,有利于疾病的恢复。通过回顾自2005年1月至2006年3月,我院收治的酒后颅脑损伤患者53例,本文认为经过临床观察治疗,采取有效的护理措施,可提高救治率,降低死亡率,现将护理体会总结如下。1临床资料本组患者中男50例,女3例,年龄18￣52岁,其中车祸伤28例,坠落伤12例,群殴致伤13例。入院时呈昏睡或昏迷状态1例,瞳孔改变8例。开放性颅脑损伤伴颅骨骨折2例,颅内血肿17例,头皮血肿及头皮裂伤5例,脑挫伤伴颅底骨折6例,脑震荡4例。2护理体会2.1心理护理酒…     

小胶质细胞参与创伤性颅脑损伤过程的研究进展

<正>创伤性脑损伤(traumatic brain injury,TBI)是神经外科常见急重症之一,其死亡率和致残率居各类创伤之首[1]。随着交通工具的逐渐普及,发展中国家的颅脑损伤发病率也呈急剧上升趋势。WHO指出,交通事故所致的损伤将在2020年位居全球疾病第三位[2]。值得注意的是,各种颅脑损伤可     

重度颅脑损伤院前急救与转运的护理体会

颅脑损伤在创伤领域占有重要的地位，它的发生率约占损伤总数的20％，仅次于四肢损伤，而死亡率却居首位。颅脑损伤病人病情重、变化快，常合并严重的多发伤、失血性休克，病情复杂，病死率高，必须分秒必争进行救治，有效的院前急救和安全转运是确保抢救成功和预后好坏的关键。现将我院2004年12月至2006年12通过“120”急救系统接诊的86例重度颅脑损伤患者的急救与转运护理报告如下。     

Minor head injuries in children

Traumatic head injury continues to be a major problem facing the pediatric specialists despite efforts to reduce its incidence. Aims of our study were assessment of the incidence of hospital admissions of children with minor head injuries, their treatment and outcome. In this prospective study we included 101 patient with head injury. We assessed the hospital admission criteria of children with minor head injuries, their length of stay, symptoms and neurological status, in-hospital imaging and consultations to other medical specialities, together with the outcome of patients on their discharge from the hospital. Of 101 patient 54 (53.46%) were male and 47 (46.53%) female. Average age was 3 years with age range from 5/52 to 12 years. Majority of patients (46.53%) were less than 1 year old. Fall was the most common mechanism of injury (92.07% of all patients). Injuries were witnessed in 51 case (50.49%), unwitnessed in 19 cases (18.81%) and unknown in 31 cases (30.69%). 95 patients did not have associated extracranial injuries, while 5 patients had associated lacerations and one had associated extracranial fracture. Length of stay was from 1 day in 80.19% of all cases to more than 2 days in 6.93%. GCS was recorded on admission and discharge and majority of patients were discharged with GCS of 15. 93% of admissions had no neurological deficit. 79% had 1 or more symptoms including vomiting, sleepiness, LOC and headaches. Over half of patients (55%) had no imaging done. 45 patients (45%) had skull x-ray. CT was performed in 7 (15%) patients and 7 fractures were found on x-ray and CT. 3 patients were admitted to ICU. All injuries were closed and all received conservative treatment. In less than 1 year old group of patients 95% of them were also seen by medical team and social worker. The outcome was good for all patients. We conclude that majority of patients with minor head injury could be supervised and observed at home by a competent care giver. Admitted patients need radiological evaluation, preferably a CT scan.     

Minimizing liability risks of head and neck injuries in football

Although catastrophic head and neck injuries in football occur infrequently, their occurrence is almost always followed by litigation. The athletic trainer has to be sure he/she has adequate liability insurance to cover the costs of a defense and a possible judgment. General claims filed against athletic staffs usually deal with instruction, equipment, matching of participants, supervision, and/or postinjury care. The defenses to these claims include: statutory immunity, assumption of risk, releases or waivers, and the reckless disregard standard. The athletic trainer plays a key role in head and neck injury prevention and care, and must be aware of litigation possibilities, along with methods of risk management. We present recommendations aimed at minimizing the risk of head and neck injuries and the risk of liability. The areas covered are: preparing for head and neck lawsuits, preventing head and neck injuries, and postcatastrophic injury care. We base these recommendations on principles that the athletic trainer can easily apply to other areas, broadening the risk management concept presented.     

Quantitative analysis of apolipoproteins and lipoprotein particles in patients with head injuries

By head-injured patients, apo A-I and apo A-II concentrations were more decreased in HDL3 than in HDL2. Then, the plasmatic concentrations of the main lipoprotein particles present in HDL fraction were modified. For example, a significant decrease of Lp A-I: A-II particles was observed and this variation was similar to that of total apo A-I (r = 0.78). On the other hand, the concentration of Lp A-I particles was slightly modified, apo C-III concentration was markedly decreased whereas apo E concentration was significantly increased (p less than 0.05); in plasma samples obtained 10 days after a severe head injury, apo E reached three times the normal value.