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颅脑创伤江基尧2016观点
$45.76
颅脑创伤的流行病学 1.目前中国尚无TBI发生率的权威性资料 2.我们建立了中国个大样本FBI住院患者数据库,并 发现患者的性别、年龄、致伤原因、Gcs、ICP值和脑疝情 况与患者预后相关 3.通过对TBI患者临床数据的分析,有助于正确引导临床 决策 4.中文版FOIJR量表虽然可用于对TBI患者昏迷程度和伤 情的评估,但仍需多中心的大宗病例研究验证其有 效性 颅脑创伤的发病机制 5.初步探讨高原颅脑战创伤发病机制,可为预防及个性化 救治提供新的思路 6.建立中国人TBI耐受性相关APoE家族生物标志 体系 7.严重颅脑创伤后的过度炎性反应可能是导致继发脑损伤 的关键环节 8.钠通道参与TBI后的继发性脑水肿 9.脑源性微粒可能是TBI—AC的关键因素 10.糖皮质激素与脑外伤后危重症应激激素分泌不足 综合征 11.弥漫性轴索损伤分子标志物的研究 颅脑创伤治疗前景展望 12.自噬增加可能是亚低温脑保护的机制之一 13.体温控制可能减少重型颅脑创伤患者的细胞凋亡从而 改善神经功能预后 14.外加电场刺激能增加人源性神经干细胞的运动能力, 诱导其定向迁移,这为颅脑创伤后的神经修复提供了 新的技术和方法 15.纳米材料介导的血脑屏障穿透性的提高,有望为 的药物治疗提供新的前景 16.他汀类药物促进慢性硬膜下血肿吸收的机制可能是调 控炎性反应和促血管生成 颅脑创伤临床新进展 17.关于地震TBI伤员的救治问题 18.阿托伐他汀可能成为慢性硬膜下血肿治疗的可选择 药物 19.建立和发展神经外科重症监护病房对提高重型TBI患 者的救治效果非常重要 20.应重视NICU中耐药鲍曼不动杆菌感染的发生,并采 取有效治疗策略 21.急性TBI患者必须动态监测颅内压变化,随时调整各 种降颅内压的措施 22.关于TBI.AC的发病与救治问题 23.临床实践中应正确严格掌握去骨瓣减压术的手术 指征 24.钻孔外引流结合腰大池引流是治疗外伤性进展型硬膜 下积液的有效方法,值得推广 25.TBI后长期昏迷的诊断和催醒方法应综合多方面因素进 行考虑 26.虽然TBI后长期昏迷患者的催醒方法较多,但由于均 缺乏严格的随机双盲对照研究,导致难以评估其临床 疗效 27.排除手术禁忌证和病情允许的前提下,对颅骨缺损患 者应尽早实施颅骨成形术 美国《重型颅脑创伤救治指南》第3版之我见 ——指南有待更多的临床证据加以补充和完善 颅脑创伤“中国指南”和“中国专家共识”之我见 颅脑创伤临床多中心随机对照研究对临床的指导价值与 争议 28.随机对照临床研究的方法学毋庸置疑,为全球TBI的 规范化救治发挥了重要作用 29.由于随机对照临床研究的局限性,不能盲目误读和无 限放大循证医学的研究结果 30.中国神经外科医师应该独立牵头开展前瞻性多中心随 机对照临床研究 31.3I的大数据时代和疗效比较研究 疑难病例分析 32.病例1:邗I后迟发性硬膜外血肿 33.病例2:脑挫裂伤 34.病例3:特重型颅脑创伤、原发性脑干伤、脑挫裂伤合 并脑内血肿、脑室出血铸型、 35.病例4:腰蛛网膜下腔置管脑脊液过度引流引发 脑疝 36.病例5:右侧颈内动脉创伤性动脉瘤 37.病例6:外伤性颈内动脉海绵窦瘘 38.病例7:颅骨开放性、凹陷性骨折 39.病例8:脑挫裂伤颅底骨折 40.病例9:开放性颅脑创伤一金属异物贯穿颅腔 41.病例10:特重型颅脑创伤并发神经源性肺水肿 42.病例ll:TBI后硬膜下积液 43.病例12:脑积水影响昏迷患者苏醒 44.病例13:TBI后昏迷患者的正中神经电刺激催醒 治疗 参考文献, 特别致谢 出版者后记
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