简明损伤定级标准（AIS）与格拉斯哥昏迷计分（GCS）对颅脑损伤？…

目的 比较单纯颅脑损伤病人ＡＩＳ－９０评定与ＧＣＳ分值的关系,对其中不符合的原因予以探讨,并提出改进设想。方法 选择单纯颅脑损伤病人１６８例（其中施行开颅血肿清除术４９例）,入院时均行ＣＴ检查,伤情分别采用ＡＩＳ－９０和ＧＣＳ评定比较。结果 ＡＩＳ５与颅脑损伤ＧＣＳ〉８分不符合的１２例主要是单纯硬膜外及硬膜下血肿,且中线移位均〈５ｍｍ。若将ＡＩＳ５血肿〉５０ｍｌ、中线结构移位≤５ｍｍ列入ＡＩＳ４,     

颅脑损伤严重度AIS与GCS的比较

颅脑损伤严重度ＡＩＳ与ＧＣＳ的比较朱政鸣程凯敏胡总结我科１９９３年７月～１９９４年１１月收治的１６８例单纯颅脑损伤病人ＡＩＳ９０与ＧＣＳ分值，比较其损伤严重度评定，对其中不相符合的原因予以探讨，并提出如何改进的设想．临床资料本组男１１７例，女５１例；...     

外伤性急性硬膜下血肿CT征象变化及其临床意义(附32例报告)

目的：研究急性硬膜下血肿ＣＴ表现与临床预后关系。方法：对３２例急性硬膜下血肿ＣＴ表现中线移位、基底池压闭及脑肿胀分别评分，结合临床病情（ＧＣＳ），研究预后相关性关系。结果：中线移位和基底池压闭明显者，其脑损伤程度严重。中线移位和基底池压闭与脑损伤积度均呈显著负相关（分别ｒ＝－０．７４４７，ｒ＝－０．６９２４，Ｐ＜０．０１），伴有急性弥漫性脑肿胀者，ＧＣＳ均在８分以下，属重型脑损伤。中线移位≥９ｍｍ者，死亡率７０．６％，基底池消失评分≥１２分，死亡率７３．３％，伴有弥漫性脑肿胀，死亡率７３．６％。结论：急性硬膜下血肿中线移位和脑池受压的程度及有否弥漫性脑肿胀对判断脑损伤程度及预后有意义     

老年人胸外伤与损伤严重度评分

目的　探讨老年人胸外伤、并发症及死亡率与ＡＩＳ／ＩＳＳ之间的关系。方法　依据ＡＩＳ－９０,应用ＩＳＳ评分方法评估６ 年来收治６３ 例（ 年龄≥６０ 岁）老年胸外伤的临床资料,并与同期２０３例（年龄≤５９ 岁） 非老年病人进行对比。结果　老年组ＩＳＳ平均１４．５±７．６,死亡５ 例（７．９％ ）;非老年组ＩＳＳ平均１７ ．９±１１,死亡７ 例（３．４％ ）。两组间ＩＳＳ和死亡率差异不显著（ Ｐ＞０ ．０５） ,老年组ＩＳＳ＞１６ 时死亡率逐渐升高（Ｐ＜０．０５）,ＩＳＳ＜ ２５ 时,并发症明显高于非老年组。死亡率随损伤部位数和最大ＡＩＳ（ＭＡＩＳ）增加而升高,当分别达到４ 时,老年组死亡率明显高于非老年组（Ｐ＜ ０．０５） 。伤前并存慢性病的老年人并发症明显增多。结论　ＩＳＳ与老年组死亡率、并发症有相关性。我国老年人年龄标准偏小（≥６０ 岁）,故两组病人损伤严重程度、死亡率差异不显著     

尼莫通治疗重型颅脑损伤与颅内压增高的关系

本院０１９９２年阴一１９９７年１０月间用尼莫通治疗重型颅脑损伤（ＳＣＩ）２８例,颅内压（ＩＣＰ）增高明显加剧１０例。现报告如下。临床资料１．病例选择：急性Ｓ＊１２８例（Ａ组）,男２０例,女８例;年龄１６－６０岁。受伤原因：交通事故８例,坠跌伤１４例,打击伤６例。ＧＣＳ评分３分６例,４－５分８例,６分８例,７－８分６例。所有病例人院时均经ＣＴ扫描诊断,脑干挫伤４例,皮质挫裂伤２４例,以额、颇叶挫裂伤为主。其中１２例伴有颅内小血肿（＜２５ｍｌ）,８例伴有颅内幕上较大血肿卜４５ｎｉｌ）,需手术处理。Ｃ…     

早期机械通气对特重型颅脑损伤患者的治疗作用

为探讨早期机械通气对特重型颅脑损伤的治疗作用及临床意义 ,笔者对1995年 6月～ 1998年 12月间 49例特重型颅脑损伤患者进行了相关的临床分析。现报告如下。资料与方法1.病例选择 :伤后 2ｈ内入院的本院首诊ＧＣＳ 3～ 5分的颅脑损伤患者 ,均经 1次以上ＣＴ确诊 ,伤或术后昏迷时间>2 4ｈ。本组共 49例 ,男 37例 ,女 12例 ,其中弥漫性轴索损伤 (ＤＡＩ) 17例 ,原发脑干损伤 12例 ,广泛脑挫伤、脑肿胀伴薄层硬膜下血肿 11例 ,特急性颅内血肿伴脑疝开颅术后 9例。ＧＣＳ评分 :3分12例 ,4分 16例 ,5分 2 1例。以交通伤为主。2 .方法 :全组 49例…     

急性硬膜下血肿的CT征象和预后关系

研究３０例急性硬膜下血肿的ＣＴ征象和预后的关系。全组死亡率４６．６％，基底池消失评分≥１２分者死亡率７０％，鞍上池消失者死亡率６８．４％，ＡＳＨ≥１０ｍｍ者死亡率６０％，脑移位≥９ｍｍ者死亡率７３．３％。存活者有四因素：①ＡＳＨ〈５ｍｍ，②脑移位〈２ｍｍ，③ＣＥＳ〈１２分，④无弥漫性脑肿胀。为了提示临床判定病情轻重，本病可分为三型：①轻型：无脑移位者，②中型：ＡＳＨ〈１０ｍｍ或脑移位〈９ｍｍ，③重     

颅脑损伤后CT估价颅内压的方法及意义

目的：探讨应用ＣＴ对闭合性颅脑损伤病人进行颅内压（ＩＣＰ）估价。方法：对１００例颅脑损伤后患者行ＣＴ扫描，分析其ＣＴ变化特征，对ＩＣＰ进行估价，并与ＩＣＰ监护值对照。ＣＴ变化特征估价内容：脑室、脑池大小形态，中线结构移位，颅内占位性损伤病灶大小。结果：下列ＣＴ改变可估价ＩＣＰ：（１）实质内血肿破入脑室，继发性梗阻性脑积水ＩＣＰ显著升高；（２）三脑室、基底池受压或消失ＩＣＰ明显升高；（３）侧脑室受压ＩＣＰ可升高；（４）中线结构移位大于５ｍｍ时ＩＣＰ升高；（５）占位性损伤灶体积小于２０ｍｌ时与ＩＣＰ升高程度无明显关系，体积大于２０ｍｌ时与ＩＣＰ升高程度相关。结论：通过ＣＴ变化，能够估价颅内压，并以此指导治疗，判断愈后。     

外伤性急性硬膜下血肿CT征象与临床预后关系

目的：研究急性硬膜下血肿ＣＴ表现与临床预后关系。方法：对１３１例急性硬膜下血肿ＣＴ表现中线移位、基底池压闭及脑肿胀分别评分，结合临床病情，研究预后关系，结果：中线移位和基底池压闭明显，其脑损伤程度严重，中红移位≥１０ｍｍ，死亡率达８２．５％，基底池消失评分≥１分，死亡率８８．７％，伴有弥漫性脑肿胀，死亡率８０．８％，结论：急性硬膜下血肿，中线移位和脑池受压的和蔼及有否弥漫性脑肿胀，对判断损伤程度及预后有重大意义。     

脑干诱发反应、CT、格拉斯哥昏迷评分联合预测急性颅脑损伤病人预后的研究

对３６例急性颅脑损伤病人在伤后４８小时内及入院后８±１天分别行脑干诱发反应（ＡＢＲ）检查，同时行ＧＣＳ评分，并结合入院时的ＣＴ扫描对病人３个月的预后进行预测．３６例病人按ＧＣＳ分组：３～５分９例，６～８分１０例，９～１２分５例，１３～１５分１２例．损...     

Knee injury and Osteoarthritis Outcome Score (KOOS) - validation of a Swedish version

The Knee injury and Osteoarthritis Outcome Score (KOOS) is a self-administered instrument measuring outcome after knee injury at impairment, disability, and handicap level in five subscales. Reliability, validity, and responsiveness of a Swedish version was assessed in 142 patients who underwent arthroscopy because of injury to the menisci, anterior cruciate ligament, or cartilage of the knee. The clinimetric properties were found to be good and comparable to the American version of the KOOS. Comparison to the Short Form-36 and the Lysholm knee scoring scale revealed expected correlations and construct validity. Item by item, symptoms and functional limitations were compared between diagnostic groups. High responsiveness was found three months after arthroscopic partial meniscectomy for all subscales but Activities of Daily Living.     

Endovascular management of carotid-cavernous fistulas

Objective To investigate endovascular treatment of traumatic direct carotid-cavernous fistulas （CCF） and their complications such as pseudoaneurysms. Methods： Over a five-year period, 22 patients with traumatic direct CCFs were treated endovascularly in our institution. Thirteen patients were treated once with the result of CCF occluded, 8 twice and 1 three times. Treatment modalities included balloon occlusion of the CCF, sacrifice of the ipsilateral internal carotid artery with detachable balloon, coll embolization of the cavernous sinus and secondary pseudoaneurysms, and covered-stem management of the pseudoaneurysms. Results All the direct CCFs were successfully managed endovascularly. Four patients developed a pseudoaneurysm after the occlusion of the CCF with an incidence of pseudoaneurysm formation of 18.2% （4/22）. A total number of 8 patients experienced permanent occlusion of the ICA with a rate of ICA occlusion reaching 36.4% （8/22）. Followed up through telephone consultation from 6 months to 5 years, all did well with no recurrence of CCF symptoms and signs. Conclusion Traumatic direct CCFs can be successfully managed with endovascular means. The pseudoaneurysms secondary to the occlusion of the CCFs can be occluded with stent-assisted coiling and implantation of covered stents.     

The role of interventional radiology in trauma

Introduction Interventional Radiology has evolved into a specialty having enormous input into the care of the traumatized patient.In all hospitals,regardless of size,the Interventional Radiologist must consider their relationships with the trauma service in order to     

Diagnóstico ecográfico del neumotórax

The ultrasonographic diagnosis of pneumothorax is based on the analysis of artifacts. It is possible to confirm or rule out pneumothorax by combining the following signs: lung sliding, the A and B lines, and the lung point. One fundamental advantage of lung ultrasonography is its easy access in any critical situation, especially in patients in the intensive care unit. For this reason, chest ultrasonography can be used as an alternative to plain-film X-rays and computed tomography in critical patients and in patients with normal plain films in whom pneumothorax is strongly suspected, as well as to evaluate the extent of the pneumothorax and monitor its evolution.     

Carbohydrate Supplementation during Exercise: Does It Help? How Much is Too Much?

KEY POINTS· Carbohydrate intake during exercise can delay the onset of fatigue and improve performance of prolonged exercise as well as exercise of shorter duration and greater intensity (e.g., continuous exercise lasting about 1h and intermittent high-intensity exercise), but the mechanisms by which performance is improved are different.     

The acutely limping child

Acute limping may be the result of multiple pathologies in children. The differential diagnosis varies based on the age of the child. Irrespective of age, the initial imaging work-up includes AP and frog leg radiographs of the pelvis and ultrasound; MRI may sometimes be helpful. In children less than 3 years, infections and trauma are most frequent. MRI is the imaging modality of choice when osteomyelitis is clinically suspected. Between the ages of 3 and 10 years, transient synovitis of the hip and Legg-Calvé-Perthes disease are main considerations but infection, inflammation and focal bony lesions are also considered. In children over 10 years, slipped capital femoral epiphysis also is considered.