创伤性脑损伤后肾功能障碍危险因素的研究进展  

Research progress on risk factors of renal dysfunction after traumatic brain injury

作　　者：司楠 孙洪涛 Nan Si;Hongtao Sun(Department of Neurosurgery,the Special Medical Center of Chinese People's Armed Police Force,Tianjin 300309,China;Institute of Neurological Injury Repair,the Special Medical Center of Chinese People's Armed Police Force,Tianjin 300309,China)

机构地区：[1]武警特色医学中心神经外科,天津300309 [2]武警特色医学中心神经创伤修复研究所,天津300309

出　　处：《中华脑科疾病与康复杂志(电子版)》2024年第5期300-305,共6页Chinese Journal of Brain Diseases and Rehabilitation(Electronic Edition)

基　　金：国家自然科学基金(32070791)

摘　　要：创伤性脑损伤(TBI)患者中约50%被收入重症监护室,其中约10%可能出现急性肾损伤(AKI)。降低颅内压(ICP)、维持脑灌注压(CPP)是防治TBI患者出现继发性脑损伤的重要手段,优化TBI治疗中ICP、CPP管理,是临床防控AKI风险切实可行的策略。通过更精准的血流动力学监测、获益更多的血管活性药物等的使用,兼顾维持颅内及肾脏的灌注压有望降低AKI的发生或进展。本文围绕TBI后AKI的研究进展展开综述,探讨潜在的TBI后诱发AKI的病理生理学机制、AKI和TBI进展之间的潜在机制,总结患有AKI或有AKI风险的TBl患者的预防和治疗策略,旨在增强临床医师对AKI的诊断和认识,为AKI的早期诊断、预防和改善患者预后提供参考。About 50%of patients with traumatic brain injury(TBI)are admitted to the intensive care unit,of which 10%may develop acute kidney injury(AKI).Reducing intracranial pressure(ICP)and maintaining cerebral perfusion pressure(CPP)are important measures for preventing and treating secondary brain injury in TBI patients.Optimizing the management of ICP and CPP in TBI treatment is a feasible strategy for clinical prevention and control of AKI risk.By more accurate blood flow dynamic monitoring and the use of more beneficial vasoactive drugs,while maintaining intracranial and renal perfusion pressure,it is expected to reduce the occurrence or progression of AKI.This article provides a review of the research progress on AKI after TBI,exploring the potential pathophysiological mechanisms of AKI induction after TBI,the potential mechanisms between AKI and TBI progression,and summarizing the prevention and treatment strategies for TBl patients with AKI or at risk of AKI.The aim is to enhance clinical physicians'diagnosis and understanding of AKI,and provide reference for early diagnosis,prevention,and improvement of patient prognosis.

关 键 词：创伤性脑损伤 急性肾损伤 危险因素 颅内压 脑灌注压 

分 类 号：R651.1[医药卫生—外科学]