脑冲击伤致伤机制和临床前治疗的研究进展  

Research progress in mechanism and preclinical treatment for blast traumatic brain injury

作　　者：吴育寿 柴家科[1] Wu Yushou;Chai Jiake(Burn Institute,Fourth Medical Center of PLA General Hospital,Beijing 100037,China)

机构地区：[1]解放军总医院第四医学中心全军烧伤研究所,北京100037

出　　处：《中华创伤杂志》2020年第5期470-474,共5页Chinese Journal of Trauma

基　　金：军队后勤重大项目(AWS15J003,ALB19J001);国家自然科学基金(81571894,81772067)。

摘　　要：平战时环境下脑冲击伤(bTBI)常造成大脑不可逆性损伤,严重危及患者生命,引起各种并发症,致死率、致残率高居不下。bTBI分为原发性损伤和继发性损伤,导致一系列神经精神症状。这主要是由于冲击波作用于机体产生物理性的裂解效应、内爆效应、惯性效应和空化效应造成的。此外,爆炸产生的弹片伤、机体被抛出撞击地面以及爆炸物体的撞击等多重机械因素均可导致脑损伤。由于bTBI常为闭合性损伤,起病较缓,容易漏诊,其发病机制复杂,临床表现各异,给诊断和治疗带来挑战。笔者就bTBI致伤机制和临床前治疗方案进行综述,为脑冲击伤的临床前治疗提供思路。Blast traumatic brain injury(bTBI)often causes irreversible damage to the brain which seriously endangers the lives of the wounded and can be accompanied by various complications,and has high disability and morbility in peacetime and wartime.The bTBI is divided into primary injury and secondary injury,resulting in a series of neuropsychiatric symptoms.The mechanism of bTBI contains cracking effect,implosion effect,inertia effect and cavitation effect.Multiple factors,such as shrapnel injury caused by explosion,collision of body being thrown with hard objects and smash of buildings,can lead to brain injury.There are challenges in the diagnosis and treatment of bTBI,because the injury is often closed,the onset is slow,the diagnosis is easy to missed,the pathogenesis is complex,and the clinical manifestations vary.The authors review the mechanism of bTBI and its preclinical treatment,hoping to provide a way for the preclinical treatment of bTBI.

关 键 词：爆震伤 脑损伤 治疗方案 

分 类 号：R826[医药卫生—临床医学]