Effect of backrest position on intracranial pressure and cerebral perfusion pressure in individuals with brain injury: a systematic review.
Effect of backrest position on intracranial pressure and cerebral perfusion pressure in individuals with brain injury: a systematic review.
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靠背位置对脑损伤患者颅内压和脑灌注压的影响：系统评价。
DOI：
10.1097/01376517-200410000-00007
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发表时间：
2004
期刊：
影响因子：
--
通讯作者：
Jun
中科院分区：
文献类型：
--
作者：
Jun
头部抬高是脑损伤患者颅内压增高的常规护理程序;其目的是通过非侵入性物理干预降低颅内压（ICP）。然而，在某些情况下，头部抬高使脑损伤个体处于继发性脑损伤的风险中，因为受损的动脉血压和受损的脑灌注压（CPP）。进行了系统的文献检索，以评估有关改变靠背位置对脑损伤个体的ICP和CPP影响的现有证据。检索到11篇文章。在9篇文章中得出的结论是，与平卧位相比，头抬高30度时ICP显著降低。9篇文章中有5篇表明，从平卧位到头抬高30度，CPP的变化幅度无统计学显著性。这11篇文章的主要局限性是样本量小和研究方案不明确，这可能导致无法检测头抬高的影响。在临床实践中，重症监护病房的工作人员需要谨慎地进行头部抬高，并充分了解其生理效应和潜在的危害。未来的研究应调查治疗体位对不同神经和神经外科人群的影响，并探索头部抬高和侧卧位的组合。
Head elevation is a conventional nursing procedure for brain-injured individuals with intracranial hypertension; it is performed with the intent of reducing intracranial pressure (ICP) by means of a noninvasive physical intervention. However, in certain circumstances, head elevation puts the brain-injured individual at risk for secondary cerebral injury because of impaired arterial blood pressure and compromised cerebral perfusion pressure (CPP). A systematic literature search was conducted to evaluate existing evidence regarding the effect of changing the backrest position on ICP and CPP in brain-injured individuals. Eleven articles were retrieved. In nine articles it was concluded that ICP significantly decreased at 30 degrees of head elevation compared with a flat position. Five of the nine articles showed no statistical significance in the magnitude of change in CPP from a flat position to 30 degrees of head elevation. Major limitations in the 11 articles were small sample sizes and unclear study protocols, which may have caused a failure to detect the effect of head elevation. In clinical practice, intensive care unit staff members need to cautiously perform head elevation with a thorough understanding of its physiologic effect and potential hazard. Future research should investigate the effects of therapeutic positions on different neurological and neurosurgical populations and explore the combination of head elevation and lateral side-lying positions.
支持家庭照顾者的团体干预措施：回顾和分析。
DOI：
10.1093/geront/29.4.438
发表时间：
1989
期刊：
The Gerontologist
影响因子：
--
作者：
Toseland,RW;Rossiter,CM
通讯作者：
Rossiter,CM
影响因子：
4.1
作者：
BOUMA, GJ;MUIZELAAR, JP;YOUNG, HF
通讯作者：
YOUNG, HF