目标温度管理在高分级动脉瘤性蛛网膜下腔出血患者中的应用进展

Research Progress of Target Temperature Management in Patients with Poor Grade Aneurysmal Subarachnoid Hemorrhage

高分级动脉瘤性蛛网膜下腔出血(poor grade aneurysmal subarachnoid hemorrage,PaSAH)患者易在发病后迅速出现意识障碍、颅内压增高以及高热等危重症状,其死亡率和致残率均很高。诸多证据表明,目标温度管理(target temperature management,TTM)可以改善心搏骤停后导致的脑损伤等疾病的预后。然而,PaSAH患者能否进行TTM仍存在争议。本文对TTM的适应证和禁忌证、多模态监测方式与前景、应用的结果、诱导方式、实施方案和不良反应的相关研究进行综述,以期为TTM应用于PaSAH提供一定的参考依据。

Patients with poor grade aneurysmal subarachnoid hemorrhage(PaSAH)are prone to rapid onset of critical symptoms such as consciousness disorder,increased intracranial pressure,and hyperthermia,which are associated with high rates of mortality and disability.Numerous evidences have shown that target temperature management(TTM)can improve the prognosis of diseases such as brain damage caused after cardiac arrest.However,whether TTM can be performed in PaSAH patients remains controversial.In this paper,indications and contraindications in PaSAH patients,multimodal monitoring modalities and prospects,outcomes of application,induction modalities,implementation protocols and adverse reactions were reviewed,with a view to providing some reference for the application of TTM in PaSAH.