重型创伤性脑损伤救治多模态监测的研究进展

摘要

Traumatic brain injury(TBI) is a major cause of death and severe disability worldwide.Currently,the monitoring methods for TBI remedy include physical examination and neuroimaging,both of which cannot realize timely and effective discovery,diagnosis and intervention of TBI and these approaches are lack of definite and individualized treatment target and cannot improve the prognosis.Intracranial pressure monitoring,brain tissue oxygen,transcranial Doppler ultrasonography,cerebral microdialysis,electroencephalography are the major methods for TBI monitoring.The multimodal monitoring is to integrate these methods to assess TBI from different dimensions and guide subsequent individualized and precision therapeutic interventions,so as to improve the clinic outcomes.%重型创伤性脑损伤(TBI)是世界范围内导致患者死亡和重度残疾的主要疾病.当前TBI救治的监测手段以体格检查、影像检查为主,其并不能及时、有效地发现、诊断、干预TBI的病理生理过程,缺乏明确的、个体化的治疗目标,不能改善患者的临床转归.颅内压监测、脑组织氧监测、脑微透析技术、脑电监测以及脑血流监测是监测TBI的重要方法.多模态监测是对这些孤立监测手段的整合,其能够从不同角度评估TBI程度,相应的目标导向治疗能够指导临床医师采取个体化、精准化的治疗方案,进而改善重型颅脑损伤患者的临床转归.