急性脊髓损伤 (Trauma)

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定义

Trauma is a serious injury or 冲击 到 body. It can affect a person's ability to function. Sometimes it can be fatal. 它需要 马上接受治疗.

Brain Trauma from Whiplash

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原因

Some causes of trauma include:

• 事故，如:
  • 机动车辆碰撞事故
  • 瀑布
  • 飞机失事
• 溺水
• Physical assault—such as attacks, gunshots, stabbing, or rape
• Burns and electrical 冲击s
• Natural disasters—such as fires, floods, earthquakes, or lightning
• 动物的攻击
• 接触体育
• 爆炸

风险因素

Trauma is more common in people aged 1 to 44 years. Other things that raise the risk are:

• Lack of car or boat safety, such as:
  • Drinking alcohol while driving
  • Using a cell phone, texting, or being distracted while driving
  • Not wearing a seatbelt or a lifejacket
  • Not using a child safety seat properly
• Improper use or storage of firearms
• Unsafe home conditions such as:
  • Objects or conditions that lead to falls
  • Not using smoke detectors or not changing dead batteries
• Not wearing proper protection—while playing sports or using dangerous equipment
• Improper use of dangerous machinery
• Fighting with fists or weapons—especially after drinking alcohol
• Lack of water safety, such as:
  • Swimming alone or without previous lessons
  • Not watching a child while they are swimming
  • Improper fencing or locks around swimming pools
• Approaching an animal unsafely or aggressively

症状

症状 depend on the type or extent of injuries. 它们可能包括:

• 疼痛
• 出血
• 呼吸困难
• 头疼, nausea, vomiting, 失忆，或改变 精神状态
• Deformity from broken bones
• Loss of feeling and/or muscle strength
• Problems urinating or passing stool
• 失去知觉或 昏迷

Emotional symptoms may be:

• 焦虑
• 愤怒和沮丧
• Acute stress disorder—distress, memories, avoidance, and feeling numb in the months after trauma
• 抑郁症
• Post-traumatic symptoms and/or disorder

诊断

A medical team will assess symptoms and health history. A physical exam will be done. It may include an exam of the chest, belly, pelvic area, 胳膊或腿. Tests may be done on the brain and nervous system.

Other tests may include:

• 心理健康检查
• 血液测试

Imaging tests may be used to check the injured area. 这些可能包括:

• 胸部x光片
• 腹部超音波
• CT扫描
• 脊柱x射线
• 血管造影术

治疗

治疗 depends on the cause, severity, or location of the injury. 选项可能是:

Immobilize and Stabilize the Injury

Severe injuries need to be stabilized. This is to help reduce further damage. 它可能需要:

• 夹板或支具
• 静脉输液
• Being monitored in the hospital
• A breathing tube for a blocked airway
• 机械通风 接管呼吸

手术

Some injuries may require surgery. This may be done right away 或晚. It depends on how severe the damage is. 例子有:

• 手术 to control bleeding
• Neurosurgery—to repair the spinal cord, brain, and/or nerves
• 创建一个 tracheostomy—to help with breathing
• Repairing or connecting broken bones with wires, screws, or plates
• Reconstructive or plastic surgery
• Removing dead tissue and skin grafting—for severe burns
• 创建一个 urostomy or 结肠造口术 恢复 bladder and bowel function—this may be temporary or permanent

Recovery and Rehabilitation

For some, recovery may be short (days or weeks). For others, it may take a long time (months or years).

In general, recovery and rehabilitation may include:

• Physical therapy—to help with movement
• Occupational therapy—to assist with everyday tasks and self-care
• Respiratory therapy—to assist with breathing
• Speech and swallowing therapy
• Psychological therapy—to improve mood and reduce depression

预防

There are many ways to reduce the risk of trauma. Learn about and practice:

• Car safety and responsible driving
• How to keep the home safe from fires, falls, and other accidents
• 船舶及水上安全
• Safety measures for recreation, sports, and using machinery
• 儿童安全
• 预防暴力
• Responsible use of alcohol and certain medicines

参考文献

• Approach 到 trauma patient. Merck Manual Professional 版本的网站. 可以在: http://www.merckmanuals.com/professional/injuries-poisoning/approach-to-the-trauma-patient/approach-to-the-trauma-patient.
• Khellaf,.， Khan, D.Z.等。. Recent advances in traumatic 脑损伤. Journal of Neurology, 2019; 266 (11): 2878-2889.
• Major trauma—emergency management. EBSCO力学网站. 可以在: http://www.力学.com/management/major-trauma-emergency-management.
• Management of chronic spinal cord injury. EBSCO力学 网站. 可以在: http://www.力学.com/management/management-of-chronic-spinal-cord-injury.
• Traumatic spinal cord injury. EBSCO力学网站. 可以在: http://www.力学.com/condition/traumatic-spinal-cord-injury.
• 创伤情况说明书. National Institute of General Medical 科学网站. 可以在: http://www.美国国家.国家卫生研究院.gov/Education/pages/Factsheet%5FTrauma.aspx.