轻度创伤性脑损伤后全科医学干预手段的应用

何晓曼; 刘玉梅; 毛旻韬; 赵志杰; 杨西涛; 郑锐哲

doi:10.16766/j.cnki.issn.1674-4152.002033

轻度创伤性脑损伤后全科医学干预手段的应用

doi: 10.16766/j.cnki.issn.1674-4152.002033

1.
上海交通大学医学院附属同仁医院麻醉手术室(SICU)，上海 200336
2.
上海交通大学医学院附属第九人民医院神经外科，上海 201999
3.
上海交通大学医学院附属同仁医院神经外科，上海 200336

基金项目:

中国博士后科学基金项目 2017M611585

上海市长宁区医学名专科项目 YXMZK005

上海交通大学医学院附属第九人民医院基础研究助推计划资助项目 JYZZ076

详细信息

通讯作者:
郑锐哲，E-mail: Ruizhedoctor@126.com

中图分类号: R197.6 R651.15
计量
- 文章访问数: 89
- HTML全文浏览量: 42
- PDF下载量: 6
- 被引次数: 0
出版历程
- 收稿日期: 2020-09-18
- 网络出版日期: 2022-02-16

Progress in the application of general practice intervention after mild traumatic brain injury

1.
Department of Intensive Care Units (Emergency and Critical Care Medicine), Tongren Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200336, China

摘要

摘要: 全世界每年有超过5 000万人遭受创伤性脑损伤(TBI)，约半数人口在其一生可能遭遇一次或以上的TBI。在TBI患者中，轻度创伤性脑损伤(mTBI)占主导，并且此类患者大多由专科医生诊治。有多数mTBI患者急性期后常常呈现出持续性、与伤害相关的日常生活能力困难及人际交往功能障碍，这说明mTBI患者的预后并非那么“轻微”。就这类症状的管理手段而言，由于存在生物心理社会因素的复杂相互作用，因此专科治疗手段对其的治疗作用有限。近年来，随着全科医学的飞速发展，利用家庭及社区等一切资源为mTBI患者提供长期的照顾以克服创伤后的低随访率和低康复率的全科医疗模式，渐渐成为国内外mTBI急性期后主要的干预手段。但对上述mTBI后的干预手段，目前最重要的决策因素是基于经验性的判断，尚未形成标准化的指南。现阶段可用于mTBI的全科干预手段有线上、线下两种模式，一般线上手段主要为以网络为基础的在线指导及程序性操作干预，线下手段主要为艺术疗法、作业疗法、音乐疗法及中医疗法。本文基于临床可用性对上述干预措施进行阐述，以期为今后“全专结合”模式的推进及普及提供借鉴。
- 轻度创伤性脑损伤 /
- 全科医学 /
- 干预手段
Abstract: More than 50 million people suffer from traumatic brain injury (TBI) every year in the world, and it is estimated that about half of the population will have one or more TBIs over their lifetime. In all TBI patients, mild traumatic brain injury (mTBI) plays the dominant role, and most of them benefiting from the diagnosis and treatment of specialists. However, a majority of mTBI patients often present with a persistent and injury related activities of daily living difficulties and interpersonal dysfunction after the acute phase of injury, which indicates that the prognosis of those patients are not so "mild". In the term of the management of such symptom, the application of specialized treatment is limited due to most symptoms are result from a complex interplay of biopsychosocial factors. Recently, with the rapid development of general practice, family and community resources are gradually using to provide long-term care for patients with mTBI to overcome the low follow-up rate and recovery rate after injury. Unfortunately, there is no standardized general practice guideline for mTBI, and the most important decision-making factors are based on the clinical practice. At present, there are two modes of general practice intervention for mTBI: online and offline. The online mode means mainly include online guidance and procedural operation intervention based on network, and the offline mode means mainly include art therapy, occupational therapy, music therapy and traditional Chinese medicine therapy. With a view to pushing the development of the "combination of general practice and special treatment" mode in the future, this article reviewed the general intervention methods that can be used in mild traumatic brain injury.
- Mild traumatic brain injury /
- General practice /
- Intervention methods

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