中枢损害的最后防线——论神经外科重症专科ICU建设  

Establishment and development of specialized neurosurgical intensive care unit:the final line of defense against neurosurgical disorders

作　　者：顾建文[1] 杨涛[1] 张修忠[1] 张新颜[1] 匡永勤[1] 卢敏[1] 冉春梅[1] 黄海东[1] 贺伟旗[1] 程敬民[1] 马原[1] 

机构地区：[1]成都军区成都总医院神经外科,成都610083

出　　处：《解放军医学杂志》2011年第2期109-111,共3页Medical Journal of Chinese People's Liberation Army

摘　　要：综合性重症监护室(ICU)的常规监测手段无法检测神经系统的早期损害,而且缺乏对神经系统损伤进行量化监护的措施,这给神经危重症的早期有效治疗带来了困难。因此,建设专业的神经外科重症监护病房(NSICU)非常重要。大型神经外科中心应该建立具有专业神经功能监测设备和治疗手段的NSICU已成为共识。除常规监护设备以外,NSICU还应配置脑组织氧饱和度、脑组织代谢、微环境、颅内压、颈静脉窦氧饱和度、脑血流量、诱发电位等指标的监测设备,还应该具备经神经科专业培训的医务人员。及时发现潜在神经损害,才能对神经损害进行精确监控、有效干预,从而减少并发症、降低死亡率。The inefficiency in detection of early-stage impairment of nervous system,if ever,and the lack of measures to quantify the impairment have raised challenges to an early and effective treatment forcritically ill patients,and the establishment of neurosurgical intensive care unit（NSICU） has become necessary.The agreement has been reached on establishment of a NSICU with specific equipments for monitoring the function of nervous system,and on development of special therapeutic techniques.Besides the routine equipments,those facilities capable of monitoring the regional oxygen saturation（rSO2）,metabolism and microenvironment of brain tissue,intracranial pressure,jugular bulb oxygen saturation（SjvO2）,blood flow and evoked potential are necessary,and personnel who are specifically trained in neurological sciences should be recruited.Only timely discovery of potential nervous lesion will make it possible to accurately monitor for an efficient intervention for the lesions,thereby complications and mortality could be reduced.

关 键 词：神经外科 重症监护 颅内压 死亡率 

分 类 号：R651[医药卫生—外科学]