外伤性脑损伤中外侧脑室引流作用的演变

Chau Charlene Y C, Craven Claudia L, Rubiano Andres M, Adams Hadie, Tülü Selma, Czosnyka Marek, Servadei Franco, Ercole Ari, Hutchinson Peter J, Kolias Angelos G

Division of Neurosurgery, Department of Clinical Neurosciences, Addenbrooke's Hospital and University of Cambridge, Cambridge Biomedical Campus, Cambridge CB20QQ, UK.

Victor Horsley Department of Neurosurgery, National Hospital for Neurology and Neurosurgery, Queen Square, London WC1N3BG, UK.

J Clin Med. 2019 Sep 10;8(9):1422. doi: 10.3390/jcm8091422.

External ventricular drains (EVDs) are commonly used in neurosurgery in different conditions but frequently in the management of traumatic brain injury (TBI) to monitor and/or control intracranial pressure (ICP) by diverting cerebrospinal fluid (CSF). Their clinical effectiveness, when used as a therapeutic ICP-lowering procedure in contemporary practice, remains unclear. No consensus has been reached regarding the drainage strategy and optimal timing of insertion. We review the literature on EVDs in the setting of TBI, discussing its clinical indications, surgical technique, complications, clinical outcomes, and economic considerations.

外置脑室引流管（EVDs）在神经外科的不同情况下普遍使用，但在创伤性脑损伤（TBI）的治疗中尤为常用，通过引流脑脊液（CSF）来监测和/或控制颅内压（ICP）。在当代实践中，当将其用作降低ICP的治疗手段时，其临床效果仍不明确。关于引流策略和最佳置入时机尚未达成共识。我们回顾了有关TBI情况下EVDs的文献，讨论其临床适应症、手术技术、并发症、临床结果及经济考量。