转诊缺口和长期头痛的危险因素在患有面骨折的患者
Bashar A Hassan1,2, Grishma Patel3, Eric Resnick3
1Division of Plastic and Reconstructive Surgery, R Adams Cowley Shock Trauma Center, Baltimore, Maryland.
Plastic and reconstructive surgery
|February 27, 2026
概括
创伤后头痛 (PTH) 在面创伤后很常见. 早期的神经学转诊对于患有先前存在的头痛或CT扫描异常的患者至关重要,以预防长期PTH.
科学领域:
- 创伤外科手术是什么
- 神经学 神经学
- 头痛的药物 头痛的药物
背景情况:
- 创伤后头痛 (PTH) 影响高达80%的轻度至中度创伤性脑损伤 (TBI) 患者,导致显著的发病率.
- 低的神经学转诊率阻碍了及时诊断和治疗,可能导致持续的头痛.
- 面创伤患者经常经历PTH,需要更好的管理策略.
研究的目的:
- 确定患有持续超过一年的创伤后头痛 (PTH) 的危险因素.
- 评估面创伤和PTH患者的神经学转诊的频率.
- 评估早期神经病学转诊对长期PTH结果的影响.
主要方法:
- 对前额,轨道或下骨折的成年患者的回顾性评估 (2018-2019).
- 主要结局:持续性或新发性PTH的频率评估伤害后1年.
- 用于确定长期PTH的风险因素的多变量逻辑回归.
主要成果:
- 在622名患者中,166人 (27%) 患有PTH,310人 (50%) 患有TBI相关症状;80%的人没有被转诊至神经科.
- 在随访时间>1年的转诊患者中,12%报告持续或新发的PTH.
- 创伤前头痛 (aOR 5) 和头部CT (aOR 4) 异常是PTH>1年的显著风险因素.
结论:
- 面骨折患者需要警的PTH监测,特别是那些患有创伤前头痛或CT扫描异常的患者.
- 建议提前转诊神经科,以预防与PTH相关的长期发病.
- 在面创伤中解决PTH对于改善患者的治疗结果和减少医疗负担至关重要.
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