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.
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。
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.
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。
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。