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| 題 名 | 難治型顱內高壓病人接受目標體溫管理之醫病共享決策=Shared Decision-Making in Targeted Temperature Management for a Patient with Refractory Intracranial Hypertension |
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| 作 者 | 許家瑜; 林恭賦; 蕭偉伶; 周聖哲; 陳以幸; | 書刊名 | 臺灣醫學 |
| 卷 期 | 30:1 2026.01[民115.01] |
| 頁 次 | 頁117-127 |
| 分類號 | 416.291 |
| 關鍵詞 | 目標溫控治療; 難治型顱內高壓; 醫病共享決策; Targeted temperature management; TTM; Refractory intracranial hypertension; Shared decision making; SDM; |
| 語 文 | 中文(Chinese) |
| DOI | 10.6320/FJM.202601_30(1).0014 |
| 英文摘要 | This case report presents the intensive care experience of a patient with intracerebral hemorrhage complicated by refractory intracranial hypertension and hyperthermia, who underwent targeted temperature management (TTM). Despite receiving multiple lines of ICP-lowering medications and surgical interventions, the patient continued to exhibit elevated ICP and body temperature. A holistic assessment framework was employed to evaluate the patient’s physiological, psychological, social, and spiritual conditions, identifying key health issues: impaired intracranial adaptive capacity, hyperthermia, and decisional conflict. To address the clinical challenges, the multidisciplinary team implemented evidence-based TTM along with a multimodal cooling strategy. This comprehensive approach enabled effective control of ICP and body temperature, reducing ICP from 18-20 mmHg to below 11 mmHg and core temperature from 38.2-39.0°C to 35.8-36.2°C, demonstrating favorable clinical outcomes. Shared decision-making was also incorporated to facilitate understanding and consensus among the patient’s family regarding treatment options. Based on this experience, it is recommended to conduct regular TTM case reviews to enhance staff competence in various stages of care and to initiate early discharge planning. These strategies aim to strengthen long-term care integration and promote holistic patient-centered care in critical settings. |
本系統中英文摘要資訊取自各篇刊載內容。