Kuhnigk H, Bomke S, Sefrin P
Institut für Anästhesiologie, Universität Würzburg.
Aktuelle Traumatol. 1993 Dec;23(8):350-3.
We measured the intracranial pressure (ICP) in 18 patients with severe head injury in the neurosurgical intensive-care unit before and after placement of a rigid collar for cervical spine immobilisation. The purpose of the study was to determine whether the rigid collars, commonly used to, prevent cervical spine movement during transport to the treatment facility could lead to an increase in ICP. Patients who had an epidural transducer in place were studied and their ICP recorded during placement of either the Spieth cervical collar (n = 12) or the Philadelphia cervical collar (n = 6). The baseline ICP was 17.0 +/- 6.1 mmHg versus 17.7 +/- 6.4 mmHg 10 min after placement of the cervical collar 5 min after removal the ICP was 17.2 +/- 5.9 mmHg. No significant changes in ICP could be demonstrated during this study. Placement of the cervical collar is a simple and practical measure to immobilize the cervical spine during rescue and transport of intubated and ventilated patients. Its risk of increasing the ICT appears to be low even in the patient with severe head injury.
我们在神经外科重症监护病房对18例重型颅脑损伤患者在佩戴用于颈椎固定的硬质颈托前后测量了颅内压（ICP）。本研究的目的是确定在转运至治疗机构期间常用的用于防止颈椎移动的硬质颈托是否会导致ICP升高。对已置入硬膜外传感器的患者进行研究，并在佩戴斯皮思颈椎固定器（n = 12）或费城颈椎固定器（n = 6）期间记录其ICP。基线ICP为17.0±6.1 mmHg，佩戴颈托10分钟后为17.7±6.4 mmHg，取下颈托5分钟后ICP为17.2±5.9 mmHg。在本研究中未发现ICP有显著变化。在对插管和通气患者进行抢救和转运期间，佩戴颈托是固定颈椎的一种简单实用的措施。即使在重型颅脑损伤患者中，其增加颅内压的风险似乎也很低。
