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2011, vol. 50, br. 3, str. 10-15
Teške kraniocerebralne povrede - preživljavanje bolesnika u odnosu na prisustvo i vrednosti intrakranijalne hipertenzije
aKlinički centar Niš, Klinika za neurohirurgiju
bKlinički centar Niš, Centar za anesteziologiju i reanimaciju

e-adresaaleko018@yahoo.co.uk
Ključne reči: traumatska moždana povreda; intrakranijalni monitoring; intrakranijalna hipertenzija
Sažetak
Razlozi porasta intrakranijalnog pritiska u traumatskoj moždanoj povredi su multipni. Važne pojave su: edem mozga, koji se razvija zbog oštećenja nervnih ćelija i krvno moždane barijere, kontuzije mozga i intrakranijalni hematomi, koji se ponašaju kao mas lezije, slom cerebrovaskularne regulacije (dovodi do porasta volumena krvi) i traumatska subarahnoidalna hemoragija (zbog poremećaja toka likvora). Cilj našeg istraživanja bio je da ispitamo preživljavanje bolesnika sa teškim moždanim traumama, u svetlu prisustva intrakranijalnog pritiska i određenih njegovih vrednosti. U ovu prospektivnu studiju uključeno je 32 bolesnika kojima je praćen intrakranijalni pritisak i preduzimana odgovarajuća terapija. Dvadeset dva bolesnika (68,75%) imala su povišene vrednosti ICP, a kod deset bolesnika (31,25%) nije bilo kriterijuma intrakranijalne hipertenzije. Rezultati naše studije pokazali su da su apsolutno smrtonosne vrednosti ICHTN 50mmHg. Nije bilo bolesnika koji su preživeli toliki ICP u trajanju dužem od 2 sata. Prilikom tolikog ICP dolazi neminovno do difuzne ishemije mozga i moždanog stabla sa zatajivanjem vitalnih funkcija. Relativno smrtonosne vrednosti bile su preko 40mmHg, gde smo samo kod jednog bolesnika uspeli pravovremenom operativnom reakcijom da sprečimo smrtni ishod.
Reference
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jezik rada: engleski
vrsta rada: izvorni naučni članak
objavljen u SCIndeksu: 27.01.2012.

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