神经重症患者继发性脑损伤监测治疗进展

Neurological intensive monitoring of patients with secondary treatment of brain injury

神经重症患者继发性脑损伤最常见原因是缺血、缺氧和颅内出血，如对疾病和脑损伤的复杂性认识不足，无疑加重了脑损伤程度及救治的最佳时机；早期或超早期了解脑组织灌注情况，对可疑患者实施无创颅内压（f—VEP）和脑状态监测（CSM），实时动态监测脑内生理、生化改变；尽早改善脑组织能量供应，遏制脑组织损伤及脑功能障碍；对不同病况急性期继发性脑损伤患者实施相对特异性的急诊救助方案，以掌握多学科专业知识，进行多学科诊断的急诊医生为主导，实施跨学科协作的急救模式，将神经重症继发性脑损伤患者监测治疗纳人“一站式”急救体系，并积极予以药物、理疗及必要的手术救治措施；从源头上降低神经重症患者继发性脑损伤的病死率。

The nerve of patients with severe brain damage with high prevalence, recurrence rate, high morbidity, high mortality, ＂four high＂ characteristics, that affect people＇s health one of the biggest hazards; cause of secondary brain injury has shown a clear upward trend, is the field of public health concern of health problems. Nerve in patients with severe secondary brain injury is the most common cause of hypoxia - ischemia and intracranial hemorrhage, doctors and the complexity of the disease level of awareness of lack of brain damage, adds to the treatment of brain injury and the best time; early or super - Early understanding of brain tissue perfusion, for patients with suspicious non - invasive intracranial pressure （f - VEP ）, brain - state monitoring （CSM）, real - time dynamic monitoring of brain physiological and biochemical changes ; as soon as possible to improve brain energy supply to curb the brain tissue damage, brain function failure; different acute illness in patients with secondary brain injury is relatively specific implementation of the emergency relief program to grasp the multidisciplinary expertise to carry out multi -disciplinary emergency medical diagnosis led the implementation of the emergency mode of cross - disciplinary collaboration, the nerve in patients with severe secondary brain injury include monitoring the treatment of ＂one -stop＂ emergency system, and actively to drugs, physical therapy and surgical treatment necessary measures; from the source to reduce mortality.