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JAMA Neurol：颅脑创伤战士的预后

2017-05-03 zhangfan MedSci原创

颅脑创伤神经行为预后
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发生颅脑创伤的战士其临床预后差，表现为持续性的病情恶化，需要医学界探索新的治疗策略

战时创伤性脑损伤(TBIs)的远期临床疗效尚未被完全知晓，当前全球冲突造成的医疗残疾成本不断上升，需要更多的脑损伤预后信息以降低沉重的公共医疗负担。研究人员开展了一项为期5年临床研究，通过收集脑损伤患者受伤一年后的临床数据确定长期残疾的早期危险因素。

研究招募50名急性亚急性期爆炸伤伤员以及44参与战事的对照士兵，所有爆炸伤伤员经国防部鉴定为轻度无并发症的颅脑创伤，临床评估包括规范评估行为、心理表现与心理健康的负担。研究主要终点是随访期间行为规范的评价、神经心理表现以及心理健康负担的变化，采用预测模型GOS-E指数识别长期残疾的早期危险因素，GOS-E指数通过整体伤残鉴、定脑损伤诊断、智力损伤、运动能力和口语流利衡量预后不良的危险因素和神经行为症状的严重程度。
。
在94名参与者中，男性87人，女性7人，平均年龄34岁，颅脑创伤患者相比于健康士兵在全脑创伤，生活满意度，神经行为症状严重程度，精神症状严重程度及睡眠障碍方面显著恶化，5年的认知措施性能评估没有显著差异。在50颅脑创伤者中，有36人(72%)在1或5年的GOS-E评估分数下降，而对照组仅有5人分数下降，对于颅脑创伤患者采用障碍与抑郁的应对措施后其症状进一步恶化。

研究表明，对于发生颅脑创伤的战士其临床预后差，表现为持续性的病情恶化，需要医学界探索新的治疗策略

原文出处：


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    2017-11-21 yinhl1978

    #Neurol#

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    2017-05-04 ms920641618706883

    #创伤#

    0

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    2017-05-04 shalley66

    #颅脑创伤#

    0

  4. 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topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160718/IMG578C993D395567540.jpg, createdBy=59b81918946, createdName=flysky120, createdTime=Thu May 04 07:41:19 CST 2017, time=2017-05-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=193566, encodeId=ed8f19356606, content=谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=64, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/Pw2csslt7CukWiabqiblnQAXaDEiaxhu025c3P0XshccTrbvGWBjKvnHIxbK3vqa80P7WGIFuicCFet97TicrNKpgB3TdabxP1vMh/0, createdBy=28851960965, createdName=榄枷檬, createdTime=Thu May 04 07:35:42 CST 2017, time=2017-05-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=193558, encodeId=04d019355837, content=学习了很好的内容, beContent=null, objectType=article, channel=null, level=null, likeNumber=67, 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objectType=article, channel=null, level=null, likeNumber=23, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/udqvoAsWtvRVficPKOpMh4M31O9bJ8jMiaUHAheeNpIqMapC8mUnBWfEskrcVjofbicWU4icRD6vFvVeEYlPmSbXELickazEGVFYO/0, createdBy=24741603767, createdName=医艺依意, createdTime=Thu May 04 07:15:04 CST 2017, time=2017-05-04, status=1, ipAttribution=)]
    2017-05-04 1e14ffd0m25(暂无匿称)

    学习

    0

  5. 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objectType=article, channel=null, level=null, likeNumber=23, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/udqvoAsWtvRVficPKOpMh4M31O9bJ8jMiaUHAheeNpIqMapC8mUnBWfEskrcVjofbicWU4icRD6vFvVeEYlPmSbXELickazEGVFYO/0, createdBy=24741603767, createdName=医艺依意, createdTime=Thu May 04 07:15:04 CST 2017, time=2017-05-04, status=1, ipAttribution=)]
    2017-05-04 1e17414fm02(暂无匿称)

    学习

    0

  6. 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objectType=article, channel=null, level=null, likeNumber=23, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/udqvoAsWtvRVficPKOpMh4M31O9bJ8jMiaUHAheeNpIqMapC8mUnBWfEskrcVjofbicWU4icRD6vFvVeEYlPmSbXELickazEGVFYO/0, createdBy=24741603767, createdName=医艺依意, createdTime=Thu May 04 07:15:04 CST 2017, time=2017-05-04, status=1, ipAttribution=)]
    2017-05-04 flysky120

    颅脑损伤预后的康复治疗很重要

    0

  7. 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topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160718/IMG578C993D395567540.jpg, createdBy=59b81918946, createdName=flysky120, createdTime=Thu May 04 07:41:19 CST 2017, time=2017-05-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=193566, encodeId=ed8f19356606, content=谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=64, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/Pw2csslt7CukWiabqiblnQAXaDEiaxhu025c3P0XshccTrbvGWBjKvnHIxbK3vqa80P7WGIFuicCFet97TicrNKpgB3TdabxP1vMh/0, createdBy=28851960965, createdName=榄枷檬, createdTime=Thu May 04 07:35:42 CST 2017, time=2017-05-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=193558, encodeId=04d019355837, content=学习了很好的内容, beContent=null, objectType=article, channel=null, level=null, likeNumber=67, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTJiaCBO9f33YY0a9cL4rhSH23PNEOVia2szWTbUl6IgFnukCuC2ptOD5mAC0Ax8qGt2pjwudkREHlmA/132, createdBy=d39e1630897, createdName=1dd8aa01m06(暂无匿称), createdTime=Thu May 04 07:26:53 CST 2017, time=2017-05-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=193556, encodeId=4c12193556d6, content=一起来涨姿势, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/07/03/04d9b9f3fcb2c24e0534b0a7de83c72e.jpg, createdBy=75672052751, createdName=月吟凤歌, createdTime=Thu May 04 07:23:58 CST 2017, time=2017-05-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=193544, encodeId=df20193544b7, content=学习了，谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=23, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/udqvoAsWtvRVficPKOpMh4M31O9bJ8jMiaUHAheeNpIqMapC8mUnBWfEskrcVjofbicWU4icRD6vFvVeEYlPmSbXELickazEGVFYO/0, createdBy=24741603767, createdName=医艺依意, createdTime=Thu May 04 07:15:04 CST 2017, time=2017-05-04, status=1, ipAttribution=)]
    2017-05-04 榄枷檬

    谢谢分享

    0

  8. [GetPortalCommentsPageByObjectIdResponse(id=1999922, encodeId=adfb1999922f9, content=<a href='/topic/show?id=d5df12695e6' target=_blank style='color:#2F92EE;'>#Neurol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=12695, encryptionId=d5df12695e6, topicName=Neurol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8217292, createdName=yinhl1978, createdTime=Tue Nov 21 14:00:00 CST 2017, time=2017-11-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1335139, encodeId=0d00133513957, content=<a href='/topic/show?id=e7cc32022c7' target=_blank style='color:#2F92EE;'>#创伤#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=32022, encryptionId=e7cc32022c7, topicName=创伤)], attachment=null, authenticateStatus=null, createdAvatar=null, 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createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/04/26/c8b491d4a115552789c06a0aff6346a7.jpg, createdBy=f1941967364, createdName=1e14ffd0m25(暂无匿称), createdTime=Thu May 04 07:57:21 CST 2017, time=2017-05-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=193599, encodeId=355919359996, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=2, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NfDEeydJz0GlP8O0ngrUX6AYCXFic0XDOOAyeQicIqnOd4TrWSwiagJrsFNYuWC1Uc6iavbS1hWt9xtZAhAqLGHqZyl/0, createdBy=42891977006, createdName=1e17414fm02(暂无匿称), createdTime=Thu May 04 07:56:37 CST 2017, time=2017-05-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=193576, encodeId=3b9e1935e64d, content=颅脑损伤预后的康复治疗很重要, beContent=null, objectType=article, channel=null, level=null, likeNumber=64, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160718/IMG578C993D395567540.jpg, createdBy=59b81918946, createdName=flysky120, createdTime=Thu May 04 07:41:19 CST 2017, time=2017-05-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=193566, encodeId=ed8f19356606, content=谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=64, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/Pw2csslt7CukWiabqiblnQAXaDEiaxhu025c3P0XshccTrbvGWBjKvnHIxbK3vqa80P7WGIFuicCFet97TicrNKpgB3TdabxP1vMh/0, createdBy=28851960965, createdName=榄枷檬, createdTime=Thu May 04 07:35:42 CST 2017, time=2017-05-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=193558, encodeId=04d019355837, content=学习了很好的内容, beContent=null, objectType=article, channel=null, level=null, likeNumber=67, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTJiaCBO9f33YY0a9cL4rhSH23PNEOVia2szWTbUl6IgFnukCuC2ptOD5mAC0Ax8qGt2pjwudkREHlmA/132, createdBy=d39e1630897, createdName=1dd8aa01m06(暂无匿称), createdTime=Thu May 04 07:26:53 CST 2017, time=2017-05-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=193556, encodeId=4c12193556d6, content=一起来涨姿势, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/07/03/04d9b9f3fcb2c24e0534b0a7de83c72e.jpg, createdBy=75672052751, createdName=月吟凤歌, createdTime=Thu May 04 07:23:58 CST 2017, time=2017-05-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=193544, encodeId=df20193544b7, content=学习了，谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=23, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/udqvoAsWtvRVficPKOpMh4M31O9bJ8jMiaUHAheeNpIqMapC8mUnBWfEskrcVjofbicWU4icRD6vFvVeEYlPmSbXELickazEGVFYO/0, createdBy=24741603767, createdName=医艺依意, createdTime=Thu May 04 07:15:04 CST 2017, time=2017-05-04, status=1, ipAttribution=)]
    2017-05-04 1dd8aa01m06(暂无匿称)

    学习了很好的内容

    0

  9. 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replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTJiaCBO9f33YY0a9cL4rhSH23PNEOVia2szWTbUl6IgFnukCuC2ptOD5mAC0Ax8qGt2pjwudkREHlmA/132, createdBy=d39e1630897, createdName=1dd8aa01m06(暂无匿称), createdTime=Thu May 04 07:26:53 CST 2017, time=2017-05-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=193556, encodeId=4c12193556d6, content=一起来涨姿势, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/07/03/04d9b9f3fcb2c24e0534b0a7de83c72e.jpg, createdBy=75672052751, createdName=月吟凤歌, createdTime=Thu May 04 07:23:58 CST 2017, time=2017-05-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=193544, encodeId=df20193544b7, content=学习了，谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=23, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/udqvoAsWtvRVficPKOpMh4M31O9bJ8jMiaUHAheeNpIqMapC8mUnBWfEskrcVjofbicWU4icRD6vFvVeEYlPmSbXELickazEGVFYO/0, createdBy=24741603767, createdName=医艺依意, createdTime=Thu May 04 07:15:04 CST 2017, time=2017-05-04, status=1, ipAttribution=)]
    2017-05-04 月吟凤歌

    一起来涨姿势

    0

  10. [GetPortalCommentsPageByObjectIdResponse(id=1999922, encodeId=adfb1999922f9, content=<a href='/topic/show?id=d5df12695e6' target=_blank style='color:#2F92EE;'>#Neurol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=12695, encryptionId=d5df12695e6, topicName=Neurol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8217292, createdName=yinhl1978, createdTime=Tue Nov 21 14:00:00 CST 2017, time=2017-11-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1335139, encodeId=0d00133513957, content=<a href='/topic/show?id=e7cc32022c7' target=_blank style='color:#2F92EE;'>#创伤#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=32022, encryptionId=e7cc32022c7, topicName=创伤)], attachment=null, authenticateStatus=null, createdAvatar=null, 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topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160718/IMG578C993D395567540.jpg, createdBy=59b81918946, createdName=flysky120, createdTime=Thu May 04 07:41:19 CST 2017, time=2017-05-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=193566, encodeId=ed8f19356606, content=谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=64, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/Pw2csslt7CukWiabqiblnQAXaDEiaxhu025c3P0XshccTrbvGWBjKvnHIxbK3vqa80P7WGIFuicCFet97TicrNKpgB3TdabxP1vMh/0, createdBy=28851960965, createdName=榄枷檬, createdTime=Thu May 04 07:35:42 CST 2017, time=2017-05-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=193558, encodeId=04d019355837, content=学习了很好的内容, beContent=null, objectType=article, channel=null, level=null, likeNumber=67, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTJiaCBO9f33YY0a9cL4rhSH23PNEOVia2szWTbUl6IgFnukCuC2ptOD5mAC0Ax8qGt2pjwudkREHlmA/132, createdBy=d39e1630897, createdName=1dd8aa01m06(暂无匿称), createdTime=Thu May 04 07:26:53 CST 2017, time=2017-05-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=193556, encodeId=4c12193556d6, content=一起来涨姿势, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/07/03/04d9b9f3fcb2c24e0534b0a7de83c72e.jpg, createdBy=75672052751, createdName=月吟凤歌, createdTime=Thu May 04 07:23:58 CST 2017, time=2017-05-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=193544, encodeId=df20193544b7, content=学习了，谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=23, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/udqvoAsWtvRVficPKOpMh4M31O9bJ8jMiaUHAheeNpIqMapC8mUnBWfEskrcVjofbicWU4icRD6vFvVeEYlPmSbXELickazEGVFYO/0, createdBy=24741603767, createdName=医艺依意, createdTime=Thu May 04 07:15:04 CST 2017, time=2017-05-04, status=1, ipAttribution=)]
    2017-05-04 医艺依意

    学习了，谢谢分享

    0

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