危重患者中无创颅内压监测技术及体位相关性进展

Progress in Non-Invasive Intracranial Pressure Monitoring Technology and Positional Correlation in Critically Ill Patients

颅内压(ICP)监测对于反应颅脑病情变化极其重要。目前的金标准仍是侵入性的颅内压测量,但由于有创操作容易出现各种并发症,并且有创监测受到患者病情,环境及体位等相关因素而无法进行普遍的应用。故此非侵入性的ICP监测手段应运而生,受到大家的关注。目前在临床中应用的非侵入性ICP测量方法主要包括通过影像、眼科、超声、电生理及其他方法来侧面反映颅内压。本文旨在对当前临床上应用相对广泛的几种非侵入性检测ICP方法,介绍其原理、适应症及部分检测手段在体位改变时所产生的相应变化。虽然这些方法并不能完全替代侵入性监测方法,但在某些特定患者及环境中,可以发挥其特殊作用。

Intracranial pressure (ICP) monitoring is extremely important for reflecting changes in the condition of the brain. The current gold standard is still invasive intracranial pressure measurement, but due to the susceptibility of invasive procedures to various complications and the limitations of invasive monitoring due to factors such as patient condition, environment, and position, it cannot be widely applied. Therefore, non-invasive ICP monitoring methods have emerged and received widespread attention. The non-invasive ICP measurement methods currently used in clinical practice mainly include imaging, ophthalmology, ultrasound, electrophysiology, and other methods to indirectly reflect intracranial pressure. This article aims to introduce the principles, indications, and corresponding changes of some non-invasive detection methods for ICP that are currently widely used in clinical practice when there is a change in posture. Although these methods cannot completely replace invasive monitoring methods, they can play a special role in certain specific patients and environments.