重症頭部外傷治療の現状：頭部外傷データバンクにおけるProject 2004の分析から

• 小野 純一

  頭部外傷データバンク検討委員会（日本神経外傷学会，日本交通科学協議会） 千葉県循環器病センター 脳神経外科

• 徳富 孝志

  頭部外傷データバンク検討委員会（日本神経外傷学会，日本交通科学協議会）

• 重森 稔

  頭部外傷データバンク検討委員会（日本神経外傷学会，日本交通科学協議会）

• 山浦 晶

  頭部外傷データバンク検討委員会（日本神経外傷学会，日本交通科学協議会）

• 中村 紀夫

  頭部外傷データバンク検討委員会（日本神経外傷学会，日本交通科学協議会）

書誌事項

タイトル別名

• Present status of treatment in severe head injury: Analysis of data in Japan Neurotrauma Data Bank

抄録

Treatment of severe head injury is still controversial despite various treatment modality has been conducted. In this study, the recent status of the treatment for the severe head injury was analyzed from the data of the Project 2004 (P2004) in the Japan Neurotrauma Data Bank (JNTDB). Among 912 cases registered in the P2004, 696 cases (76%) with a Glasgow Coma Scale (GCS) score 8 or less on admission were enrolled in this study. Those were divided into 3 groups, according to the CT findings of the Traumatic Coma Data Bank: Diffuse injury (DI) in 293 cases, mass lesion (ML) in 385 cases, and unknown in 8. The clinical features, the treatment and the outcome were compared with those in the Project 1998 (P1998). Results: 1) Patient's age was older in the P2004, but GCS score, injury severity score, and the proportion of DI and ML did not differ significantly between two groups. 2) Prescription of hyperosmotic agent and anticonvulsants, and barbiturate therapy were less frequent in the DI group of the P2004. On the other hand, hyperosmotic agent was less frequently given and hypothermia was less conducted in the ML group. 3) Evacuated mass was significantly decreased in the P2004. In addition, both internal or external decompression and ventricular drainage were less performed in the P2004. Placement of an intracranial pressure sensor was also less common in the P2004. 4) Outcome at discharge: Mortality rate was reduced in both the DI and the ML groups of the P2004. These results suggested that the active treatment for the severe head injury had been reduced recently, but the mortality had been also decreased. The reason of these data was unable to be interpreted, so that further study will be necessary to establish the recent trend of the treatment.

収録刊行物

• 神経外傷

  神経外傷 30 (1), 1-6, 2007-12-27

  一般社団法人 日本脳神経外傷学会

キーワード

• Japan Neurotrauma Data Bank
• Severe head injury
• Clinical features
• Treatment
• Outcome

詳細情報

• CRID: 1390574036148243456
• NII論文ID: 10031136360
• NII書誌ID: AN00358577
• DOI: 10.32187/neurotraumatology.30.1_1
• ISSN: 24343900
• Web Site: https://search.jamas.or.jp/link/ui/2008179369
• 本文言語コード: ja
• データソース種別:
  • JaLC
  • CiNii Articles
• 抄録ライセンスフラグ: 使用不可