冲击波致创伤性脑损伤的暴露阈值研究：胸部和加速机制
Working toward exposure thresholds for blast-induced traumatic brain injury: thoracic and acceleration mechanisms
摘要：
对爆炸引起的肺损伤的研究得出了暴露阈值，这有助于了解和保护人类免受这种损伤。由于爆炸暴露引起的创伤性脑损伤（TBI）已成为一个突出的医学和军事问题，因此应确定类似的阈值，以便将现有的研究结果置于背景中，并指导未来的研究，以保护战士以及诊断和治疗。至少有三种机械机制，爆炸波可能导致脑损伤已被提出-胸部机制，头部加速和直接颅传输。这些机制不必相互排斥。在这项研究中，前两个机制的基础上爆炸特性（正脉冲持续时间和峰值有效超压）的可能感兴趣的区域开发使用现有的数据从爆炸实验和相关研究，包括后装甲钝伤和弹道压力波的研究。这些相关的研究是适当的，因为产生爆炸样的压力波，导致神经系统的影响，如爆炸引起的。结果表明，每种机制的损伤阈值取决于爆炸条件，在某些条件下，可能有一种以上的机制。由于头部加速度和/或胸部机制，有一部分冲击波条件可能导致TBI，但不伴有肺损伤。这些结果可用于指导实验设计，并在获得更多数据时进行比较。在描述给定暴露的TBI的实际概率或严重性之前，需要额外的数据。
英文摘要：
Research in blast-induced lung injury resulted in exposure thresholds that are useful in understanding and protecting humans from such injury. Because traumatic brain injury (TBI) due to blast exposure has become a prominent medical and military problem, similar thresholds should be identified that can put available research results in context and guide future research toward protecting warfighters as well as diagnosis and treatment. At least three mechanical mechanisms by which the blast wave may result in brain injury have been proposed - a thoracic mechanism, head acceleration and direct cranial transmission. These mechanisms need not be mutually exclusive. In this study, likely regions of interest for the first two mechanisms based on blast characteristics (positive pulse duration and peak effective overpressure) are developed using available data from blast experiments and related studies, including behind-armor blunt trauma and ballistic pressure wave studies. These related studies are appropriate to include because blast-like pressure waves are produced that result in neurological effects like those caused by blast. Results suggest that injury thresholds for each mechanism are dependent on blast conditions, and that under some conditions, more than one mechanism may contribute. There is a subset of blast conditions likely to result in TBI due to head acceleration and/or a thoracic mechanism without concomitant lung injury. These results can be used to guide experimental designs and compare additional data as they become available. Additional data are needed before actual probabilities or severity of TBI for a given exposure can be described.
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