Neurological Surgery 脳神経外科47巻7号

2019年07月発行

研究

重症急性硬膜下血腫における頭蓋内圧亢進の予測因子に関する検討

著者： 清平美和¹ 末廣栄一¹ 藤山雄一¹ 鈴木倫保¹

所属機関： ¹山口大学大学院医学系研究科脳神経外科学講座

ページ範囲：P.753 - P.760

Ⅰ．はじめに
　重症頭部外傷患者における神経集中治療の目的は，二次性脳損傷の予防である．頭蓋内圧亢進は脳灌流圧を低下させ，二次性脳損傷により患者転帰が増悪するため，頭蓋内圧管理は厳重に行われなければならない²⁾．また，頭蓋内圧亢進に対する治療は，内科的処置から外科的処置へと段階的に行うとされている．これらの処置の適切なタイミングを逃すと，脳ヘルニアとなり不可逆的な脳損傷に陥ってしまう．そこで，リアルタイムな頭蓋内圧測定が必要であり，また，頭蓋内圧亢進が予測される患者には，高度な管理体制の準備が重要となる．こうした管理体制を置くことにより，二次性脳損傷を最小限に抑えることが可能となり，患者転帰に寄与することが期待される．
　そこで本研究では，当院に搬入された重症急性硬膜下血腫患者を対象に，頭蓋内圧亢進を予測し得る因子について後方視的に検討した．

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