Borel C, Hanley D, Diringer M N, Rogers M C
Department of Neurology, Johns Hopkins Medical Institutions, Baltimore.
Chest. 1990 Jul;98(1):180-9. doi: 10.1378/chest.98.1.180.
Intensive management of patients with severe head injury offers the best hope of minimizing death and functional disability in a young, working population. Secondary neurologic insult can be decreased by cardiorespiratory support and ICP control from the outset. Rapid neurologic assessment, airway management, and support of circulation are the basis of emergency management for head injury. Patients with severe head injury require intensive care management for two major reasons: management of ICP and management of organ system dysfunction. Care should not be withheld because of initially grim (and inaccurate) prognostic assessment. Newer techniques for assessing the adequacy of cerebral circulation may allow refinement of management strategies in the future.
对严重颅脑损伤患者进行强化管理，为年轻的劳动人群将死亡和功能残疾降至最低提供了最大希望。从一开始通过心肺支持和颅内压控制可减少继发性神经损伤。快速的神经学评估、气道管理和循环支持是颅脑损伤急诊处理的基础。严重颅脑损伤患者需要强化护理管理主要有两个原因：颅内压管理和器官系统功能障碍管理。不应因最初严峻（且不准确）的预后评估而放弃治疗。评估脑循环充足性的新技术可能会在未来使管理策略得到优化。
