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运动相关脑震荡是许多运动中十分常见的神经损伤。脑震荡并非一定有外在表现,而且运动员可能因为不了解该症状或担心无法参赛而不及时报告,所以很多脑震荡实际上未被确诊。脑震荡的不当治疗会导致后续伤害风险增加。本文概括了运动相关脑震荡控制的各个方面,包括准备(计划)、教育、评价、治疗、决定回归赛场,以及脑震荡的长期影响。其中,准备和教育是必须的初始步骤,可促使脑震荡的潜在负面影响最小化。对于脑震荡疑似患者,须采用多层面方法进行评价,例如体检以及对体征和症状、神经认知和平衡的评估。控制脑震荡应包括身体和认知两方面的休息,以及交通、睡眠、工作、学术等方面的因素。对伤后回归赛场的运动员,应依照渐进回归方案,密切监控其症状。因为近来有多发性脑震荡各种累积效应的报告,所以运动医学临床人员应持续关注脑震荡控制的相关信息并采用保守疗法。
Exercise related concussion is a very common nerve injury in many sports. Concussions are not necessarily outward manifestations, and many athletes may not actually be diagnosed because they may not be promptly reported because they do not understand the symptoms or are afraid of being unable to compete. Improper treatment of concussions can increase the risk of subsequent injury. This article outlines various aspects of exercise-related concussion control, including preparation (planning), education, evaluation, treatment, decision to return to the playing field, and the long-term effects of concussion. Among them, preparation and education are necessary initial steps to minimize the potential negative impact of concussions. Patients with suspected concussion should be assessed using a multidimensional approach such as physical examination and assessment of signs and symptoms, neurocognitive and balance. Control of concussion should include both physical and cognitive rest, as well as transportation, sleep, work, academic and other factors. Athletes returning to the arena should be monitored for their symptoms in accordance with a gradual return plan. Because of recent reports of various cumulative effects of multiple concussions, sports medicine clinicians should continue to focus on concussion-related information and adopt conservative therapies.