美军创伤性脑损伤战术战场防治方案及产品研发进展

Tactical combat casualty care programs and product development for traumatic brain injury in U.S. Army

创伤性脑损伤(traumatic brain injury,TBI)已经成为现代战争的特征性创伤之一,美军非常注重战场上TBI的预防和救治。战术战伤救治指南(tactical combat casualty care,TCCC)明确规定了其预防和救治的流程,制订了相应的策略和方案,提高了战场救治效果。美军战场TBI评估方法主要有:急性脑震荡评估法(military acute concussion evaluation,MACE)、AVPU(alert,voice,pain,unresponsive)评估法、格拉斯哥昏迷指数评估法。本文重点分析了MACE评估法及其评估流程;解读了美军战场上TBI的救治方案措施及流程,包括轻型TBI和中重度TBI的救治方案措施、脑疝的预防;并阐述了美军战场TBI最新预防和救治设备。以上经验做法对我军的启发包括加强战场TBI救治指南和流程的制订、战场上配套TBI相应的诊断设备和救治人员、加强军民融合研发新型TBI防治设备。

Traumatic brain injury （TBI） has become one of the characteristic traumas of modern warfare. The U.S. Army attaches great importance to the prevention and treatment of TBI on the battlefield. Tactical combat casualty care （TCCC） clearly stipulated its prevention and rescue procedures, formulated corresponding strategies and plan, and improved the effectiveness of battlefield treatment. The TBI evaluation methods of the U.S. Army on the battlefield included military acute concussion evaluation （MACE）, AVPU （alert, voice, pain and unresponsive） scale, and Glasgow coma scale （GCS）. In the article, we introduce and analyze the MACE evaluation and its processes in detail, systematically analyze the TBI treatment measures and procedures on the battlefield, including treatment measures for mild TBI and moderate and severe TBI, and prevention of cerebral palsy. At the same time, we also introduce the TBI latest prevention and treatment equipment on the battlefield. The enlightenment of the above experience for our military includes strengthening the formulation of the TBI treatment guidelines and procedures on the battlefield, supporting the corresponding diagnostic equipment and rescue personnel, and strengthening the integration of military and civilian research and development of new TBI prevention equipment.