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[创伤性脑损伤后颅内高压的循证重症监护治疗]

[Evidence-based intensive care treatment of intracranial hypertension after traumatic brain injury].

作者信息

Pannen B H J, Loop T

机构信息

Anaesthesiologische Universitätsklinik, Universitätsklinikum Freiburg.

出版信息

Anaesthesist. 2005 Feb;54(2):127-36. doi: 10.1007/s00101-004-0785-y.

Abstract

Traumatic brain injury (TBI) occurs frequently and is associated with a poor prognosis. Severe TBI results in substantial disability or death in more than 40% of cases. The major aim of treatment of these patients is to minimize secondary brain injury and in this respect, the prevention of intracranial hypertension plays a key role. In addition to surgical approaches, various conservative treatment options exist, such as the use of osmodiuretics, barbiturates, or corticosteroids, hyperventilation as well as induced therapeutic hypothermia. This review analyzes these treatment options and the therapeutic goals of lowering intracranial pressure (ICP) in patients after TBI using evidence-based criteria, and provides recommendations for clinical practice.

摘要

创伤性脑损伤(TBI)很常见,且预后不良。在超过40%的病例中,严重的创伤性脑损伤会导致严重残疾或死亡。治疗这些患者的主要目标是将继发性脑损伤降至最低,在这方面,预防颅内高压起着关键作用。除了手术方法外,还存在各种保守治疗选择,如使用渗透性利尿剂、巴比妥类药物或皮质类固醇、过度通气以及诱导性治疗性低温。本综述使用循证标准分析了这些治疗选择以及创伤性脑损伤后患者降低颅内压(ICP)的治疗目标,并为临床实践提供建议。

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