摘要目的 分析中国和欧盟创伤性脑损伤(TBI)救治中心结构特征、医院设施和工作流程的主要差异,并据此进行疗效比较分析.方法 设计工作特征问卷,招募中国45家医院(中国组)和欧洲71家医院(欧盟组)参加欧洲神经创伤疗效比较研究(CENTER-TBI),收集中国组和欧盟组的结构特征、医院设施、工作流程等,分析工作特征特点及差异.结果 中国组直升机平台设施[31％(14/45):80％(57/71)]的比例低于欧盟组(P<0.01),神经外科ICU配备[98％(44/45):57％(40/71)]的比例则高于欧盟组(P<0.01).中国组配备全日急诊手术室[96％(43/45):75％(53/71)]、开放式ICU[27％(12/45):4％(3/71)]、过渡病床[93％(42/45):71％(50/71)]的比例较高(P<0.01);欧洲组更多实施脑实质颅内压监测[31％(21/67):7％(344)],采用20 mmHg为颅高压管理阈值[86％(57/66):64％(29/45)](P<0.01).同时,中国组更多采用基础生命支持,采用美国TBI指南进行临床管理.结论 中国和欧盟TBI救治中心的结构和工作流程差异显著,主要体现在神经外科ICU配备、全日急诊手术室、脑实质颅内压监测及颅内压管理阈值方面.这一差异为进一步在TBI领域进行疗效比较研究并确定最佳临床实践提供了基础.

abstractsObjective To explore the major differences of the provider profiles in terms of structural characteristics, hospital facilities and workflow of traumatic brain injury ( TBI) centers between China and European Union and compare the efficacy. Methods The questionnaires were designed focusing on the provider profiling, and 45 Chinese centers and 71 European centers were recruited into Collaborative European NeuroTrauma Effectiveness Research in TBI ( CENTER-TBI) program. The structural characteristics, hospital facilities and work flow of the two groups were compared. Results The proportion of helicopter platform facilities[31％ (14/45)] : 80％ (57/71)]in China group was lower than that in European Union group (P <0. 01), while the proportion of neurological ICU facilities [98％ (44/45) : 57％ (40/71)] in China group was higher than that in European Union group (P <0. 01). China group has higher ratios in all-day trauma operation room [96％(43/45):75％(53/71)], open ICU [27％(12/45):4％(3/71)], transitional beds[93％(42/45):71％(50/71)] than those in European Union group (P<0.01). European Union group had higher ratios in implementing brain parenchymal intracranial pressure monitoring [31％ (21/67) :7％ (344)] and adopting 20 mmHg as the threshold of intracranial hypertension [86％(57/66):64％(29/45)](P<0.01). The China group adopted more basic life support and followed the US TBI guidelines for clinical management. Conclusions Significant differences are disclosed upon TBI centers between China and EU, mainly demonstrated in neurological ICU facilities, all-day trauma operation room, brain parenchymal intracranial pressure monitoring, and the threshold of intracranial hypertension management. These differences provide a working analysis basis for further comparative studies in the field of TBI and for determining the best clinical practice.