中西醫結合早期治療腦外傷重度昏迷病例報告

Early Intervention with Integrated Chinese and Western Medicine in Severe Traumatic Brain Injury-A Case Report

鄭凱文(Kai-Wen Cheng) ； 黃健財(Chien-Tsai Huang) ； 張源驛(Yuan-Yi Chang) ； 侯毓昌(Yu-Chang Hou)

《中醫藥雜誌》 26卷1期 (2015/06) Pp. 73-82

https://doi.org/10.3966/101764462015062601007

摘要

本病例報告為一位24歲女性患者，因機車車禍導致神智嚴重昏迷，昏迷指數一度僅3分，屬重度昏迷，於傷後第四天會診中醫，開始中西醫結合治療，患者約於接受21天後成功拔管，轉出加護病房並持續改善，並於創傷後期開始加入頭皮針治療，取得良好的療效，此早期中醫藥物搭配針灸合併治療介入的經驗，可作為中西醫合作縮短腦創傷患者重度昏迷時間、減少病患住院天數以及提升療效之參考。

關鍵字

創傷性腦傷 ； 意識昏迷 ； 中西醫結合

並列摘要

This 24 years old female suffered motorcycle traffic accident and led to loss of consciousness due to severe traumatic brain injury. In ER, the Glasgow coma scale was E1V1M1 then she was admitted to our SICU for further management. At the 4th day of admission, the Chinese Medicine was consulted and then the Chinese herbal treatment was started. After 21 days of integrated treatment, the patient was successfully extubation and transferred to general ward care. The scalp acupuncture was combined for later treatment and also got well recover. It provides us a strong experience of early intervention with integrated Chinese and Western medicine for severe traumatic brain injury.

並列關鍵字

Traumatic brain injury ； loss of consciousness ； integrated Chinese and Western medicine

參考文獻

衛生福利部：民國101 年死因統計年報，101年死因統計結果分析，2013/07/16 更新 (http://www.mohw.gov.tw/cht/DOS/DisplayStatisticFile.aspx?d=13718&s=1)。

Hemphill JC, Phan N. Traumatic brain injury: Epidemiology, classification, and pathophysiology. In: UpToDate, BasowDS (Ed), UpToDate, Waltham, MA, 2012 (last updated: April 13th, 2013).

Leibson, CL,Brown, AW,Hall, Long K,Ransom, JE,Mandrekar, J,Osler, TM,Malec, JF(2012).Medical care costs associated with traumatic brain injury over the full spectrum of disease: a controlled populationbased study.J. Neurotrauma.29(11),2038-2049.

Ponsford, JL,Spitz, G,Cromarty, F,Gifford, D,Attwood, D(2013).Costs of care after traumatic brain injury.J. Neurotrauma.30(17),1498-1505.

季帥、張軍平、呂仕超、楊萃(2013)。基於心腦同治學說探討冰片的臨床運用。中醫雜誌。2，114-117。