TREATMENT OF INTRACRANIAL HYPERTENSION
TREATMENT OF INTRACRANIAL HYPERTENSION
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DOI：
10.1007/bf01405391
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发表时间：
1977-01-01
影响因子：
2.4
通讯作者：
GHOSTINE, SY
中科院分区：
文献类型：
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作者：
JAMES, HE;LANGFITT, TW;GHOSTINE, SY
对95例患者在3年内进行了连续性颅内压（ICP）记录（105），使用Scott套管通过钻孔或麻花钻孔插入侧脑室前角。临床诊断为颅脑损伤、颅内肿瘤、动脉瘤和动静脉畸形、继发于全身疾病的脑肿胀和病因不明的脑肿胀。在86个记录中，ICP超过20 mm Hg（最大110 mm Hg）。48例患者使用高渗甘露醇73次。除3次给药外，所有给药组ICP均降低10%或以上（平均52%）。在34例患者的50项试验中测试了过度通气的效果。在34项试验中，ICP降低10%或更多（平均47%）。ICP最大降低的平均时间为8分钟，在过度通气停止后，ICP几乎立即恢复到控制状态。在40例患者的40项试验中研究了低温。半数患者ICP降低10%或以上（平均51%）。4家医院的感染率为6.3%，但6例感染中有4例发生在1家医院。若排除该医院，感染率为3.1%。
Consecutive recordings (105) of intracranial pressure (ICP) were made in 95 patients over a 3 yr period, using a Scott cannula inserted through a burr hole or a twist drill hole into the anterior horn of the lateral ventricle. The clinical diagnoses were head injury, intracranial tumor, aneurysm and arteriovenous malformation, brain swelling secondary to systemic disease and brain swelling of unknown etiology. ICP exceeded 20 mm Hg in 86 of the recordings (maximum 110 mm Hg). Hypertonic mannitol was administered 73 times in 48 patients. ICP was reduced 10% or more (mean 52%) in all but 3 administrations. The effect of hyperventilation was tested in 50 trials in 34 patients. ICP was reduced 10% or more (mean 47%) in 34 trials. The mean time to maximum reduction of ICP was 8 min, and ICP returned to control almost immediately after cessation of hyperventilation. Hypothermia was studied in 40 trials in 40 patients. ICP was reduced 10% or more (mean 51%) in half the patients. The infection rate was 6.3% in 4 hospitals, but 4 of the 6 infections were in 1 hospital. If this hospital were excluded, the infection rate was 3.1%.