Ogden Alfred T, Mayer Stephan A, Connolly E Sander
The Neurological Institute, Department of Neurological Surgery, Columbia University, New York, New York 10032, USA.
Neurosurgery. 2005 Aug;57(2):207-15; discussion 207-15. doi: 10.1227/01.neu.0000166533.79031.d8.
Medical management of cerebral edema and elevated intracranial pressure (ICP) is a critical component of perioperative care in neurosurgical practice. Traumatic brain injury, arterial infarction, venous hypertension/infarction, intracerebral hemorrhage, subarachnoid hemorrhage, tumor progression, and postoperative edema can all generate clinical situations in which ICP management is a critical determinant of patient outcomes. Although osmotic agents are among the most fundamental tools to control ICP, prospective data to establish clear guidelines on their use are lacking. Hypertonic saline is emerging as an alternative to mannitol. Early data suggest that indications for each agent may ultimately depend on ICP etiology.
脑水肿和颅内压（ICP）升高的药物治疗是神经外科手术围手术期护理的关键组成部分。创伤性脑损伤、动脉梗死、静脉高压/梗死、脑出血、蛛网膜下腔出血、肿瘤进展和术后水肿均可导致临床情况，其中ICP管理是患者预后的关键决定因素。尽管渗透性药物是控制ICP最基本的工具之一，但缺乏建立明确使用指南的前瞻性数据。高渗盐水正在成为甘露醇的替代药物。早期数据表明，每种药物的适应证可能最终取决于ICP的病因。
