加强二次脑损伤因素的循证医学研究

目的分析近十年来国内外二次脑损伤因素的循证医学研究进展,提出该领域未来的研究方向和重点。方法应用情报学调研方法,检索、整理和分析近十年来二次脑损伤因素的研究成果和最新动态。结果近十年来,二次脑损伤因素的研究取得了长足进步,已明确高热、低氧血症、低血压、颅内压增高、脑灌注压下降、心律失常、电解质紊乱及酸碱平衡失调等二次脑损伤因素参与了继发性脑损害的病理生理过程。但是,监测二次脑损伤的时机及其意义尚需更进一步的循证医学研究证据给予支持。结论防治二次脑损伤引起的继发性脑损害,是提高重型颅脑损伤救治水平的关键。

Evidence-based medical study to enhance secondary brain injury factors

Objective To analyze the progress in evidence-based medical study on secondary brain injury factors during the past 10 years,in order to propose the future research direction and important areas in this field.Methods The achievements and latest tendency in the study of secondary brain injury factors during the last 10 years were retrieved from the literature,and they were duly arranged and analyzed.Results Remarkable progress has been made in the study of secondary brain injury during the last 10 years.Many factors in the pathophysiological process participating in the production of second brain damage,such as hyperpyrexia,hypoxemia,hypotension,increased intracranial hypertension,decreased cerebral perfusion pressure,arrhythmia,electrolyte disturbances,acid-base imbalance,etc.,have been identified.However,for the opportune time of monitoring secondary brain damage and the significance of these findings,further evidence-based study is still necessary.Conclusion The prevention and treatment of secondary brain injury induced by various brain damage factors are the keys to improving the level of treatment of severe brain injury.