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| 題 名 | The Classification and Risk Factors of Mild Head Injury=輕度頭部外傷之分類及危險因子 |
|---|---|
| 作 者 | 紀煥庭; 邱文達; 楊大羽; 蔡行瀚; | 書刊名 | 臺灣急診醫學會醫誌 |
| 卷 期 | 9:2 2007.06[民96.06] |
| 頁 次 | 頁31-38 |
| 分類號 | 416.14 |
| 關鍵詞 | 輕度頭部外傷; 昏迷指數; 危險因子; Mild head injury; Glasgow Coma Scale; GCS; Risk factors; |
| 語 文 | 英文(English) |
| 中文摘要 | 背景:探討目前對於輕度頭部外傷的定義,以昏迷指數Glasgow Coma Scale (GCS)大於13分以上做為分類是否恰當?方法:利用回溯性的研究,在兩年期間共收集到GCS在13-15的輕度頭部外傷,總共4271人。探討其臨床表現並分析會增加顱內出血機會的危險因子。結果:其中970人(22.7%)電腦斷層結果發現有顱內出血,334(7.8%)需接受開顱手術以及237人(5.5%)預後不佳。我們歸納出八項危險因子,包括:男性、入院時GCS不到15分、意識喪失、傷後失憶、痙攣、神經障礙、顱骨骨折、年紀大於65歲。結論:傷患GCS在13-15之間,其實臨床的差異是蠻大的。當傷患的GCS是13或14時,通常比較容易有嚴重的傷害。目前的輕度頭部外傷的定義可能讓人產生錯誤的印象,甚至造成疏失;因為其實傷害的結果可能不是“輕度”。我們建議,應該將GCS 13-15的傷患再細分為“輕度頭部外傷”及“高危險群輕度頭部外傷”。“輕度頭部外傷”定義為GCS 15且電腦斷層正常;“高危險群輕度頭部外傷”定義為GCS13、14或15但電腦斷層異常者。 |
| 英文摘要 | Aim: Evaluate the current definition of mild head injury and judge if GCS (Glasgow Coma Scale) 13 is a good critical value. Methods: A retrospective study of 4271 patients with mild head injury (GCS score 13-15) during a 2-year period. Their clinical manifestations were analyzed statistically to find the risk factors of intracranial lesions, neurosurgical intervention and poor outcome. Results: 970 (22.7%) patients had intracranial lesions proven by computed tomography (CT) of the head, 334 (7.8%) needed neurosurgical intervention and 237(5.5%) had an unfavorable outcome. Eight risk factors were found: male, GCS score lower than 15, initial loss of consciousness, post-traumatic amnesia, seizures, focal signs, presence of skull fractures, and old age (°Ÿ65). Conclusion: We suggest that mild head injury is defined as a GCS score of 15 without acute radiographic abnormalities, whereas high-risk mild head injury is defined as a GCS score of 13 or 14, or a GCS score of 15 with acute radiographic abnormalities. |
本系統中英文摘要資訊取自各篇刊載內容。