创伤性脑水肿的治疗现状与进展

Present Condition and Progress in Treatment of Traumatic Brain Edema

我国每年死于创伤者可达数十万,其中约50%是死于致命性颅脑创伤。颅脑创伤具有高死亡率,即使通过治疗挽留患者生命,其术后生存质量并不理想,给家庭以及社会造成巨大负担,已经成为一个严重的公共卫生问题。颅脑创伤者均有不同程度脑水肿出现。创伤性脑水肿是颅脑遭受重创后的严重继发性的病理生理反应,过多水分在脑细胞内外间隙聚集,使脑体积增大,致使颅内高压加重,严重时患者出现脑疝或脑移位。颅脑创伤患者多死于脑水肿。因此,脑水肿疗效直接决定颅脑创伤患者的预后。本文从创伤性脑水肿的发病机制、分类、治疗等方面对创伤性脑水肿的治疗及现状进行综述,旨在为今后提高创伤性脑水肿疗效、改善颅脑创伤患者预后提供可参考的依据。

Annually hundreds of thousands of people die of trauma every year in our country,about 50% of them die of fatal craniocerebral trauma.The mortality of craniocerebral trauma is high and postoperative quality of life is not ideal even the lives of patients are saved by treatment,which posing a severe burden to families and society.Craniocerebral trauma has been a serious public health problem.The patients with cerebral trauma show different degree of cerebral edema.Traumatic brain edema is secondary pathological physiological reaction when the cerebra suffers from serious brain damage.Excessive moisture assembles in the gap inside and outside of cerebral cells,which enlarging the brain volume, aggravating the intracranial pressure and even causing cerebral hernia or brain shift.Cerebral edema is a main death cause of the injured with craniocerebral trauma.Therefore,the efficacy on brain edema directly determines the prognosis of patients with craniocerebral trauma.The treatment and the present conditions of traumatic brain edema are summed in this paper from the pathogenesis,classification,treatment and other aspects,which aiming at providing the reference basis for improving the treatment efficacy of traumatic brain edema and the prognosis of patients with craniocerebral trauma.