頁籤選單縮合
題名 | Advances in Intensive Care of Neurosurgical Patients=神經外科病患重症照護之進展 |
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作 者 | 李旭東; 王有智; 楊大羽; | 書刊名 | 中華民國重症醫學雜誌 |
卷期 | 4:2 2002.04[民91.04] |
頁次 | 頁107-117 |
分類號 | 419.73 |
關鍵詞 | 神經外科病患; 神經加護照顧; 腦部監測; Neurosurgical patient; Neurointensive care; Cerebral monitoring; |
語文 | 英文(English) |
中文摘要 | 神經加護照顧一直是神經外科病患照護最重要的一環並且主要面對的是大腦二度傷害,缺氧則是造成大腦二度傷害最主要的,因此維持足夠的灌注壓和降低大腦的代謝率,成為現今神經加護照顧主要的課題。 為了避免二度腦傷的發生或是它的傷害達到最少程度,因此需要良好的腦部監測系統以便能夠及時找出問題進而解決問題,是故腦部監測系統的研發與進步與神經加護照顧進展息息相關。 細數腦部監測系統的發展從早期的神經學檢查及生理監測,顱內壓監測、經顱骨杜卜勒超音波到中期的腦部代謝性監測,腦部氧飽和度監測,及進展到近期的神經電生理監測,神經代謝監測,及可以監測到腦間質組織中的變化。其目的均在於早期偵測出腦部的問題,適時處理。目前的趨勢偏像於多重監測與局部監測,而臨床醫師則需要自愈來愈多能夠得到的數據中,小心謹慎研判各種結果找出其相關性,使得神經外科病患得到更加完善的照護,並進而應用於其他神經系統疾病重症病患之照護。 |
英文摘要 | Neurointensive care is important in the management of neurosurgical patients, and ischemia is thought to be the most important “secondary brain injury.” Maintenance of adequate cerebral perfusion and decreasing the cerebral metabolism have become the main issues of the current neurointensive care. Neurologic monitoring is directed toward assuring that as normal an intracranial milieu as possible be maintained. There has been an evolution in monitoring philosophy from following only those parameters which were associated with philosophy from following only those parameters which were associated with correcting a deranged central nervous system (CNS) status (i.e., intracranial pressure [ICP] and cerebral perfusion pressure [CPP]) to also following parameters which are concerned with maintaining as normal a status as possible (cerebral blood flow [CBF], evoked potential [EP]). It is likely that in the near future there will be a general trend toward multiple monitoring systems. the aim of various monitoring systems. The aim of various monitoring systems is to detect the abnormalities of the brain as early as possible and manage to avoid secondary insults. Multimodality cerebral monitoring is more convenient in clinical practice, but the increased bias should be considered. |
本系統之摘要資訊系依該期刊論文摘要之資訊為主。