Gilsbach J M, Mayfrank L, Lennartz B
Neurochirurgische Universitätsklinik, RWTH Aachen.
Chirurg. 1996 Nov;67(11):1114-22. doi: 10.1007/s001040050112.
Aggressive treatment of patients with severe head injury increases the chance for survival and good functional outcome in most cases. To prevent irreversible cerebral lesions, the key point of treatment is the management of intracranial hypertension caused by intracranial hematomas, brain edema and impaired circulation of cerebrospinal fluid (CSF). Therapeutic standards are surgery of traumatic hematoma, osmotherapy and mild hyperventilation for brain edema, and CSF drainage. In highly elevated intracranial pressure (ICP) administration of barbiturates and forced hyperventilation can be considered.
对重度颅脑损伤患者进行积极治疗在大多数情况下可提高生存几率和获得良好的功能预后。为防止不可逆性脑损伤,治疗的关键在于处理由颅内血肿、脑水肿和脑脊液(CSF)循环障碍引起的颅内高压。治疗标准包括外伤性血肿手术、针对脑水肿的渗透疗法和轻度过度通气以及脑脊液引流。对于颅内压(ICP)高度升高的情况,可考虑使用巴比妥类药物和强制过度通气。