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・頭部外傷の診療では,初期診療の標準化コース(JATEC)や『頭部外傷治療・管理のガイドライン』などの標準化されたアプローチが確立されており,防ぎ得た外傷死を回避するために初期診療が重要である.
・近年,頭部外傷患者の高齢化,抗血栓薬服用者の増加,死亡率は低下しているものの転帰良好の割合も低下している.
・頭部外傷患者は凝固線溶異常を伴うことが多く,早期のトラネキサム酸の投与,適切な抗凝固薬の中和療法を行う.
To reduce the number of preventable trauma deaths(PTD), a standardized approach has been established with various training courses and guidelines such as the Japan Advanced Trauma Evaluation and Care and Guidelines for the Diagnosis and Treatment of Traumatic Brain Injury.
To prevent PTD, initial treatment, including resuscitation, is crucial in the care of traumatic brain injury(TBI).
The Japan Neurotrauma Data Bank recently reported that the number of patients with TBI is increasing. Patients on antithrombotic drugs are also increasing. Although the mortality rate is decreasing, the percentage of patients with favorable outcomes is also decreasing.
Therefore, to prevent secondary brain injury, rapid and systematic assessment of physiological abnormalities and resuscitation using the ABCDE approach, diagnosis and treatment of impending D, administration of tranexamic acid(an antifibrinolytic drug), and timely administration of anticoagulant neutralizers are important.
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