摘要
轻型脑创伤通常是指患者受伤后格拉斯哥评分在13~15分,且昏迷时间不超过30 min、失忆时间不超过24 h。轻型脑创伤在我国及全世界有着数量庞大的发病人群,大部分患者伤后能够很快恢复正常的工作和生活,但仍有部分患者存在长期的症状以至于无法重返工作岗位,给患者及家庭造成沉重的经济及心理负担。这些患者虽然大部分没有表现出明显的影像学结构异常,但通常伴随着各种功能障碍,且临床症状复杂多样,包括头痛、头晕、记忆力下降、嗅觉丧失、听力下降、视力下降、情绪问题、睡眠问题等。由于患者临床表现多样化,所以往往需要多学科医生联合治疗才能达到较好的预后,而得益于近年来全科医学的发展,在整合各学科医疗资源、对患者的长期随访方面有着天然的优势。重返工作岗位在患者康复过程中具有里程碑式意义,标志着患者能够重新开始融入社会,而尽早地重返工作,对于患者的康复也有着积极影响。当前国外的一些研究指出影响轻型脑创伤患者重返工作的因素包括社会人口学因素、疾病本身因素、心理因素、社会支持等。本文对于该领域研究进行总结,期望能够早期识别有高风险无法重返工作的患者,并尽早开始针对性康复治疗,帮助患者克服躯体及心理上的困难,从而更快地回归社会和工作生活中去。
Mild traumatic brain injury(TBI)usually refers to the patients with Glasgow coma scale of 13-15 after the injury,and the duration of coma does not exceed 30 minutes and the duration of amnesia does not exceed 24 hours.There are a large number of TBI patients in China and around the world.Most patients can quickly return to normal work and life after the injury,but some patients still have long-term symptoms and cannot return to work,causing a heavy economic and psychological burden on the patients and their families.Although most of these patients do not show obvious structural abnormalities,they are usually accompanied by various functional disorders,and the clinical symptoms are complex and varied,including headache,dizziness,memory loss,loss of smell,hearing loss,vision loss,emotional problems,sleep problems,etc.Due to the diversity of clinical manifestations in patients,multidisciplinary therapies are often required to achieve a better prognosis.Thanks to the development of general practice in recent years,it has natural advantages in the integration of medical resources from various disciplines and the long-term follow-up of patients.Returning to work is a milestone in patients'recovery,marking the point at which patients can begin to reintegrate into society,and returning to work as early as possible has a positive impact on patients'recovery.Currently,some foreign studies have pointed out that the factors affecting the return to work of patients with mTBI include social demographic factors,disease factors,psychological factors,social support and so on.This paper summarizes the research in this field,hoping to identify high-risk patients who cannot return to work at an early stage,and start targeted rehabilitation treatment as soon as possible,to help patients overcome physical and psychological difficulties,so as to return to the society and work more quickly.
作者
薛钦
马力
刘伟明
聂增尧
XUE Qin;MA Li;LIU Weiming;NIE Zengyao(Department of General Practice,Beijing Tiantan Hospital,Capital Medical University,Beijing 100070,China;不详)
出处
《中华全科医学》
2023年第6期1012-1015,1038,共5页
Chinese Journal of General Practice
基金
北京市卫生健康科技成果和适宜技术推广项目(BHTPP202034)
首都全科医学研究专项(21QK03)。
关键词
轻型脑创伤
重返工作
全科医学
Mild traumatic brain injury
Return to work
General practice
作者简介
通信作者:聂增尧,E-mail:niezengyao1968@sina.com。
