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颅内压联合脑组织氧分压监测在颅脑外伤治疗中的作用
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Abstract:
颅脑损伤是临床上常见的急症之一，主要由外界暴力伤害所致，比如高空坠落、交通事故、异物严重撞击等，其致残率和致死率均较高，且易处于脑组织缺血缺氧状态，发生低氧血症、低血压症，对患者的日常生活带来极大的不良影响，对家庭和社会也带来重大负担。颅内压(Intracranial pressure, ICP)和脑组织氧分压(partial pressure of brain tissue oxygen, PbtO2)监测并管理显著降低了颅脑损伤患者的死亡率。ICP作为反应颅内顺应性指标的概念，是对几个世纪前Monroe和Kellie提出的学说，与标准颅内压指导治疗相比，ICP联合PbtO2监测指导治疗相结合被认为可以改善创伤性脑损伤(Traumatic brain injury, TBI)患者的预后。本文将对ICP联合PbtO2监测对TBI患者治疗中的临床意义和前景进行综述。
Brain injury is one of the common clinical emergencies, mainly caused by external violent injuries, such as falling from high altitude, traffic accidents, severe impact of foreign objects, etc. It has high disability rate and high fatality rate. In hypoxic state, hypoxemia and hypotension occur, which have a great adverse effect on the daily life of the patient, and also bring a heavy burden to the fam-ily and society. Monitoring and management of intracranial pressure Intracranial pressure (ICP) and partial pressure of brain tissue oxygen (PbtO2) can significantly reduce the mortality of patients with traumatic brain injury. The concept of ICP as an indicator of intracranial compliance is based on the theory proposed by Monroe and Kellie centuries ago, and the combination of ICP combined with PbtO2 monitoring-guided therapy is believed to improve traumatic brain injury compared with standard intracranial pressure-guided therapy (Traumatic brain injury, TBI) patients’ prognosis. This article will review the clinical significance and prospects of ICP combined with PbtO2 monitor-ing in the treatment of TBI patients.
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