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中华重症医学电子杂志 ›› 2015, Vol. 01 ›› Issue (01) : 48 -52. doi: 10.3877/cma.j.jssn.2096-1537.2015.01.012

所属专题: 重症医学 文献

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重症颅脑损伤:病理生理学与治疗
周建新1,*,*   
  1. 1. 100050,首都医科大学附属北京天坛医院重症医学科
  • 收稿日期:2015-07-10 出版日期:2015-11-28
  • 通信作者: 周建新
  • 基金资助:
    北京市医管局重点医学专业发展计划(ZYLX201502); 北京市医管局"登峰"人才培养计划(DFL20150502)

Severe brain injury: pathophysiology and treatment

Jianxin Zhou1   

  1. 1. Department of Critical Care Medicine, Beijing Tiantan Hospital, Capital Medical University, Beijing 100050, China
  • Received:2015-07-10 Published:2015-11-28
  • Corresponding author: Jianxin Zhou
  • About author:
    Corresponding author: Zhou Jianxin, Email: zhoujx.cn@gmail.com
引用本文:

周建新. 重症颅脑损伤:病理生理学与治疗[J/OL]. 中华重症医学电子杂志, 2015, 01(01): 48-52.

Jianxin Zhou. Severe brain injury: pathophysiology and treatment[J/OL]. Chinese Journal of Critical Care & Intensive Care Medicine(Electronic Edition), 2015, 01(01): 48-52.

颅内压升高、脑血管自身调节功能失常和血脑屏障损害,是急性重症颅脑损伤的三大重要病理生理学特点。针对这些病理生理学特点,形成了以颅内压/脑灌注压为目标的,以及以脑毛细血管静水压和胶体渗透压为目标的救治策略。目前临床研究存在的主要问题是对于不同患者群体,以及不同疾病进展时间窗的鉴别。这也构成了今后的主要研究方向。

Intracranial hypertension, impaired cerebral vascular auto-regulation and disrupted brain blood barrier are the three major pathophysiological characteristics in patients with severe brain injury. In accordance with these characteristics, strategies have been carried out either to control the intracranial pressure and cerebral perfusion pressure, or to regulate cerebral capillary hydrostatic pressure and oncotic pressure. The differentiation of patients with different pathophysiology and during different time windows is important factor related to clinical outcome. And this warrants further investigation.

图1 重症颅脑损伤的死亡率和不良神经系统功能转归发生率[1,2]
图2 以颅内压/脑灌注压为导向的颅脑损伤分级治疗策略[13]
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