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controlled trial\uff0cRCT\uff09\u7b49\u8bc1\u636e\uff0c\u68c0\u7d22\u6570\u636e\u5e93\u5305\u62ecWeb of Science\u3001PubMed\uff0c\u8c37\u6b4c\u5b66\u672f\u3001\u4e2d\u56fd\u77e5\u7f51\uff08CNKI\uff09\u3001\u4e07\u65b9\u6570\u636e\u5e93\u3001\u4e2d\u56fd\u751f\u7269\u533b\u5b66\u6587\u732e\u670d\u52a1\u7cfb\u7edf\u7b49\u4e2d\u3001\u82f1\u6587\u6570\u636e\u5e93\uff0c\u68c0\u7d22\u65f6\u95f4\u6bb5\u4e3a\u4ece\u5efa\u5e93\u5f00\u59cb\u81f32023\u5e744\u6708\u3002\u7ecf\u5171\u8bc6\u5236\u8ba2\u5c0f\u7ec4\u8ba8\u8bba\uff0c\u7ed3\u5408\u5faa\u8bc1\u533b\u5b66\u8bc1\u636e\u548c\u4e13\u5bb6\u610f\u89c1\uff0c\u786e\u5b9a\u672c\u5171\u8bc6\u5bf9\u4ee5\u4e0b5\u4e2a\u65b9\u9762\u8fdb\u884c\u5185\u5bb9\u66f4\u65b0\uff0c\u5305\u62ec\uff1a\u2460\u795e\u7ecf\u91cd\u75c7\u60a3\u8005\u9547\u75db\u9547\u9759\u6cbb\u7597\u7684\u76ee\u7684\uff1b\u2461\u795e\u7ecf\u91cd\u75c7\u60a3\u8005\u5728\u9547\u75db\u9547\u9759\u6cbb\u7597\u8fc7\u7a0b\u4e2d\u7684\u76d1\u6d4b\uff1b\u2462\u9547\u75db\u9547\u9759\u836f\u7269\u9009\u62e9\uff1b\u2463\u9547\u75db\u9547\u9759\u6cbb\u7597\u5728\u96be\u6cbb\u6027\u9885\u5185\u9ad8\u538b\uff08refractory intracranial hypertension\uff0cRIH\uff09\u4e2d\u7684\u5e94\u7528\uff1b\u2464\u9547\u75db\u9547\u9759\u6cbb\u7597\u5728\u76ee\u6807\u6e29\u5ea6\u7ba1\u7406\uff08targeted temperature management\uff0cTTM\uff09\u4e2d\u7684\u5e94\u7528\u3002<\/p>\n<p>\u672c\u5171\u8bc6\u91c7\u7528\u6539\u826f\u5fb7\u5c14\u83f2\u6cd5\uff0c\u6700\u7ec8\u5f62\u6210\u4e00\u4efd\u4ee5\u5faa\u8bc1\u533b\u5b66\u8bc1\u636e\u4e3a\u57fa\u7840\uff0c\u7ed3\u5408\u4e13\u5bb6\u7ec4\u6210\u5458\u610f\u89c1\u7684\u4e13\u5bb6\u5171\u8bc6\u30022023\u5e747\u6708\u81f38\u6708\u8fdb\u884c3\u8f6e\u5fb7\u5c14\u83f2\u95ee\u5377\u8c03\u67e5\u53ca\u9762\u5bf9\u9762\u4f1a\u8bae\u3002\u95ee\u5377\u5185\u5bb9\u4e3b\u8981\u5305\u62ec\u9488\u5bf9\u6bcf\u4e2a\u63a8\u8350\u610f\u89c1\u7684Likert\u91cf\u8868\u8bc4\u5206\u53ca\u53ef\u81ea\u7531\u586b\u5199\u7684\u610f\u89c1\u548c\u5efa\u8bae\u533a\u57df\u3002\u9488\u5bf9\u6bcf\u4e00\u6761\u63a8\u8350\u610f\u89c1\uff0c\u91c7\u7528Likert 5\u7ea7\u91cf\u8868\uff085-point Likert scale\uff09\u8fdb\u884c\u8bc4\u5206<sup>[4\uff0c5]<\/sup>\uff0c\u5f97\u5206\u4ece1\u5206\uff08\u975e\u5e38\u4e0d\u540c\u610f\uff09\u52305\u5206\uff08\u975e\u5e38\u540c\u610f\uff09\uff0c\u8fbe\u6210\u5171\u8bc6\u7684\u89c4\u5219\u5982\u4e0b\uff1a\u82e5\u53c2\u4e0e\u5171\u8bc6\u6295\u7968\u7684\u4e13\u5bb6\u975e\u5e38\u540c\u610f\u6216\u540c\u610f\u8be5\u6761\u63a8\u8350\u610f\u89c1\u7684\u6bd4\u4f8b\u226575%<sup>[6]<\/sup>\uff0c\u5219\u8fbe\u6210\u5171\u8bc6\uff0c\u6700\u7ec8\u5f62\u621031\u6761\u63a8\u8350\u610f\u89c1\uff08\u88681\uff09\u3002\u672c\u5171\u8bc6\u4e13\u5bb6\u63a8\u8350\u7a0b\u5ea6\u4ee5&#8217;\u5171\u8bc6\u5ea6&#8217;\u6807\u6ce8\uff0c\u5171\u8bc6\u5ea6\uff1d\u8bc4\u5206\u22654\u5206\u7684\u4e13\u5bb6\u6570\/\u4e13\u5bb6\u603b\u6570\u00d7100%\uff0c\u6b63\u6587\u4e2d\u6bcf\u6761\u5177\u4f53\u63a8\u8350\u610f\u89c1\u540e\u6807\u6ce8\u5171\u8bc6\u5ea6\u548c\u8bc4\u5206\u22654\u5206\u7684\u4e13\u5bb6\u6570\/\u4e13\u5bb6\u603b\u6570\u3002<\/p>\n<p>\u4e66\u7c4d\u5e7f\u544a<\/p>\n<\/p>\n<p>\u4e66\u7c4d\u5e7f\u544a<\/p>\n<p>3\u3000\u795e\u7ecf\u91cd\u75c7\u60a3\u8005\u9547\u75db\u9547\u9759\u6cbb\u7597\u7684\u76ee\u7684<\/p>\n<p>\u4e34\u5e8a\u95ee\u98981\uff1a\u795e\u7ecf\u91cd\u75c7\u60a3\u8005\u5e94\u7528\u9547\u75db\u9547\u9759\u6cbb\u7597\u7684\u76ee\u7684\u662f\u4ec0\u4e48\uff1f<\/p>\n<p>\u80cc\u666f\uff1a\u91cd\u75c7\u60a3\u8005\u5904\u4e8e\u91cd\u75c7\u52a0\u5f3a\u533b\u7597\u75c5\u623f\uff08intensive care unit\uff0cICU\uff09\u73af\u5883\u4e2d\uff0c\u7531\u4e8e\u539f\u53d1\u75be\u75c5\u3001\u533b\u7597\u62a4\u7406\u64cd\u4f5c\u5e26\u6765\u7684\u75bc\u75db\uff0c\u5bf9\u4e8e\u75be\u75c5\u9884\u671f\u548c\u8fdc\u79bb\u5bb6\u4eba\u5e26\u6765\u7684\u6050\u60e7\u53ca\u7126\u8651\uff0c\u5404\u79cd\u58f0\u5149\u7b49\u523a\u6fc0\u9020\u6210\u7684\u7761\u7720\u969c\u788d\uff0c\u540c\u65f6\u91cd\u75c7\u60a3\u8005\u4ea6\u5e38\u5904\u4e8e\u5e94\u6fc0\u72b6\u6001\u800c\u51fa\u73b0\u5fc3\u52a8\u8fc7\u901f\u3001\u4eba\u673a\u5bf9\u6297\u3001\u7ec4\u7ec7\u6c27\u8017\u589e\u52a0\uff0c\u751a\u81f3\u5f15\u8d77\u8c35\u5984\uff0c\u5bfc\u81f4\u975e\u8ba1\u5212\u62d4\u7ba1\u7b49\u4e0d\u826f\u4e8b\u4ef6\uff0c\u56e0\u6b64\u9547\u75db\u9547\u9759\u6cbb\u7597\u5728\u91cd\u75c7\u60a3\u8005\u4e2d\u5177\u6709\u91cd\u8981\u4f5c\u7528\uff0c\u5176\u57fa\u672c\u76ee\u7684\u5305\u62ec\u51cf\u8f7b\/\u6d88\u9664\u75bc\u75db\u3001\u7126\u8651\u3001\u8e81\u52a8\uff0c\u6539\u5584\u7761\u7720\uff0c\u51cf\u8f7b\u5e94\u6fc0\u7b49\u3002<\/p>\n<p>\u795e\u7ecf\u91cd\u75c7\u60a3\u8005\u5e38\u9762\u4e34\u66f4\u4e3a\u590d\u6742\u7684\u60c5\u51b5\u3002\u9664\u4e0a\u8ff0\u60c5\u51b5\u5916\uff0c\u795e\u7ecf\u91cd\u75c7\u60a3\u8005\u5e38\u4f34\u6709\u795e\u7ecf\u529f\u80fd\u969c\u788d\uff0c\u5982\u610f\u8bc6\u969c\u788d\u60a3\u8005\u5e38\u56e0\u7f3a\u4e4f\u6c14\u9053\u4fdd\u62a4\u6027\u53cd\u5c04\u800c\u4fdd\u7559\u4eba\u5de5\u6c14\u9053\uff0c\u636e\u7edf\u8ba1\uff0c\u9ad8\u8fbe20%\u7684\u6025\u6027\u795e\u7ecf\u7cfb\u7edf\u75be\u75c5\u4f4f\u9662\u60a3\u8005\u9700\u8981\u6c14\u7ba1\u63d2\u7ba1\u548c\u673a\u68b0\u901a\u6c14<sup>[7]<\/sup>\u3002\u795e\u7ecf\u91cd\u75c7\u52a0\u5f3a\u533b\u7597\u5355\u5143\uff08neurocritical care unit\uff0cNCU\uff09\u60a3\u8005\u5e73\u5747\u673a\u68b0\u901a\u6c14\u65f6\u95f4\u4e3a18 h<sup>[8]<\/sup>\uff0c\u4e14\u4eba\u673a\u5931\u8c03\u7684\u73b0\u8c61\u666e\u904d\u5b58\u5728<sup>[9]<\/sup>\u3002\u5bf9\u4e8e\u6025\u6027\u671f\u7684\u795e\u7ecf\u91cd\u75c7\u60a3\u8005\uff0c\u4ea4\u611f\u795e\u7ecf\u5174\u594b\u4e5f\u662f\u5e38\u89c1\u7684\u8868\u73b0\u4e4b\u4e00<sup>[10]<\/sup>\u3002\u7efc\u4e0a\uff0c\u7ed3\u5408\u795e\u7ecf\u91cd\u75c7\u60a3\u8005\u9762\u4e34\u7684\u76d1\u62a4\u73af\u5883\u3001\u533b\u7597\u62a4\u7406\u64cd\u4f5c\u548c\u8eab\u4f53\u7ea6\u675f\u72b6\u6001\u7b49\uff0c\u9547\u75db\u9547\u9759\u6cbb\u7597\u5728\u51cf\u8f7b\u5e94\u6fc0\u3001\u75bc\u75db\u3001\u7126\u8651\u3001\u8e81\u52a8\uff0c\u540c\u65f6\u6539\u5584\u4eba\u673a\u5931\u8c03\u3001\u63d0\u9ad8\u8212\u9002\u6027\u3001\u6291\u5236\u4ea4\u611f\u795e\u7ecf\u5174\u594b\u6027\u3001\u964d\u4f4e\u8111\u4ee3\u8c22<sup>[11\uff0c12]<\/sup>\u7b49\u65b9\u9762\u53d1\u6325\u7740\u91cd\u8981\u7684\u4f5c\u7528\uff0c\u8fd9\u4e9b\u90fd\u4e3a\u5efa\u7acb\u7a33\u5b9a\u7684\u795e\u7ecf\u4fdd\u62a4\u5960\u5b9a\u4e86\u57fa\u7840\u30022019\u5e74\uff0c\u5728\u897f\u96c5\u56fe\u56fd\u9645\u4e25\u91cd\u9885\u8111\u521b\u4f24\u5171\u8bc6\u4f1a\u8bae\uff08the Seattle International Severe Traumatic Brain Injury Consensus Conference\uff0cSIBICC\uff09\u63d0\u51fa\u7684\u5206\u7ea7\u6cbb\u7597\u7b56\u7565\u4e2d\uff0cT1~T3\u9636\u6bb5\u7684\u9547\u75db\u9547\u9759\u6cbb\u7597\u5e94\u4ee5\u964d\u4f4e\u9885\u5185\u538b\uff08intracranial pressure\uff0cICP\uff09\u4e3a\u76ee\u6807\uff0c\u5b9e\u73b0\u8111\u4fdd\u62a4<sup>[13]<\/sup>\u3002\u8fd9\u662f\u795e\u7ecf\u91cd\u75c7\u60a3\u8005\u7684\u7279\u6b8a\u6027\uff0c\u5373\u5982\u4f55\u9884\u9632\u548c\u51cf\u8f7b\u8111\u635f\u4f24\u540e\u7684\u4e8c\u6b21\u4f24\u5bb3\u3002\u9664\u6b64\u4e4b\u5916\uff0c\u4e00\u4e9b\u7279\u6b8a\u60c5\u51b5\u5982TTM\u3001\u96be\u6cbb\u6027\u766b\u75eb\u6301\u7eed\u72b6\u6001\u3001\u9635\u53d1\u6027\u4ea4\u611f\u795e\u7ecf\u5174\u594b\uff08paroxysmal sympathetic hyperactivity\uff0cPSH\uff09\u7b49\u53ef\u4ee5\u8003\u8651\u8fdb\u884c\u9547\u75db\u9547\u9759\u6cbb\u7597\u3002<\/p>\n<p>\u8bc1\u636e\u603b\u7ed3\uff1a2019\u5e74SIBICC\u4e2d\u63d0\u51fa\u5173\u4e8e\u91cd\u578b\u9885\u8111\u635f\u4f24\uff08severe traumatic brain injury\uff0csTBI\uff09\u60a3\u8005\u7684\u57fa\u7840\u6551\u6cbb\u63aa\u65bd\uff0c\u5305\u62ec\u9547\u75db\u9547\u9759\u4ee5\u51cf\u8f7b\u75bc\u75db\u3001\u9884\u9632\u8e81\u52a8\u3001\u6539\u5584\u4eba\u673a\u4e0d\u540c\u6b65\u7b49\uff1b\u5f53\u60a3\u8005\u6709ICP\u589e\u9ad8\u7684\u98ce\u9669\u65f6\uff0c\u5e94\u5728ICP\u76d1\u6d4b\u6307\u5bfc\u4e0b\u91c7\u53d6\u5f3a\u5316\u9547\u75db\u9547\u9759\u4ee5\u964d\u4f4eICP<sup>[13]<\/sup>\u3002\u6b64\u524d\uff0c2017\u5e74\u7f8e\u56fd\u8111\u5916\u4f24\u57fa\u91d1\u4f1a\u5b66\u4f1a\u7b2c4\u7248\u300a\u91cd\u75c7\u521b\u4f24\u6027\u9885\u8111\u635f\u4f24\u7ba1\u7406\u6307\u5357\u300b\u4e5f\u6307\u51fa\uff0c\u9547\u75db\u9547\u9759\u662f\u6cbb\u7597sTBI\u5e38\u7528\u7684\u91cd\u8981\u624b\u6bb5\uff0c\u5176\u4f5c\u7528\u5305\u62ec\u9884\u9632\u6216\u63a7\u5236\u9885\u5185\u9ad8\u538b\uff08intracranial hypertension\uff0cIH\uff09\uff0c\u4ee5\u53ca\u6cbb\u7597\u766b\u75eb<sup>[14]<\/sup>\u3002<\/p>\n<p>\u63a8\u8350\u610f\u89c11\uff1a\u9547\u75db\u9547\u9759\u662f\u795e\u7ecf\u91cd\u75c7\u60a3\u8005\u6cbb\u7597\u7684\u91cd\u8981\u7ec4\u6210\u90e8\u5206\u4e4b\u4e00\u3002\u795e\u7ecf\u91cd\u75c7\u60a3\u8005\u5e94\u7528\u9547\u75db\u9547\u9759\u6cbb\u7597\u7684\u4e00\u822c\u76ee\u7684\u662f\u51cf\u8f7b\/\u6d88\u9664\u75bc\u75db\u3001\u7126\u8651\u3001\u8e81\u52a8\uff0c\u6539\u5584\u7761\u7720\u5e76\u8bf1\u5bfc\u9057\u5fd8\uff0c\u51cf\u8f7b\u5e94\u6fc0\uff0c\u964d\u4f4e\u6c27\u8017\uff0c\u63d0\u9ad8\u8212\u9002\u6027\uff0c\u6539\u5584\u4eba\u673a\u5931\u8c03\u3002\uff08\u5171\u8bc6\u5ea6\uff1a100%\uff1b36\/36\uff09<\/p>\n<p>\u63a8\u8350\u610f\u89c12\uff1a\u5bf9\u5b58\u5728IH\u7b49\u7ee7\u53d1\u6027\u8111\u635f\u4f24\u98ce\u9669\u7684\u795e\u7ecf\u91cd\u75c7\u60a3\u8005\uff0c\u9547\u75db\u9547\u9759\u6cbb\u7597\u7684\u76ee\u7684\u5e94\u517c\u987e\u8111\u4fdd\u62a4\u5c42\u9762\uff0c\u5305\u62ec\u63a7\u5236ICP\u3001\u7ef4\u6301\u8111\u704c\u6ce8\u3001\u6291\u5236\u4ea4\u611f\u795e\u7ecf\u5174\u594b\u3001\u63a7\u5236\u766b\u75eb\u53d1\u4f5c\u548c\u9884\u9632\/\u51cf\u8f7b\u7ee7\u53d1\u6027\u8111\u635f\u4f24\u7b49\u3002\uff08\u5171\u8bc6\u5ea6\uff1a100%\uff1b36\/36\uff09<\/p>\n<p>\u4e66\u7c4d\u5e7f\u544a<\/p>\n<p>\u4e34\u5e8a\u95ee\u98982\uff1a\u795e\u7ecf\u91cd\u75c7\u60a3\u8005\u51fa\u73b0IH\u65f6\u662f\u5426\u5e94\u8fdb\u884c\u9547\u75db\u9547\u9759\u6cbb\u7597\uff1f<\/p>\n<p>\u80cc\u666f\uff1aIH\u662f\u795e\u7ecf\u91cd\u75c7\u60a3\u8005\u5371\u53ca\u751f\u547d\u7684\u4e25\u91cd\u5e76\u53d1\u75c7\u3002\u63a7\u5236ICP\u7684\u57fa\u672c\u63aa\u65bd\u5305\u62ec\u5165\u4f4fICU\u3001\u6c14\u7ba1\u63d2\u7ba1\u548c\u673a\u68b0\u901a\u6c14\u3001\u795e\u7ecf\u7cfb\u7edf\u8bc4\u4f30\u3001\u5e8a\u5934\u62ac\u9ad8\u3001\u9884\u9632\u4eba\u673a\u4e0d\u540c\u6b65\u3001\u6e29\u5ea6\u7ba1\u7406\u3001\u4fdd\u6301\u6c14\u9053\u901a\u7545\u3001\u76d1\u6d4b\u4e2d\u5fc3\u9759\u8109\u538b\uff08central venous pressure\uff0cCVP\uff09\u548c\u547c\u6c14\u672b\u4e8c\u6c27\u5316\u78b3\u3001\u7ef4\u6301\u8840\u7ea2\u86cb\u767d&gt;70 g\/L\u3001\u6301\u7eed\u8840\u6d41\u52a8\u529b\u5b66\u76d1\u6d4b\u7b49\uff0c\u9547\u75db\u9547\u9759\u6cbb\u7597\u4e5f\u662f\u91cd\u8981\u7ec4\u6210\u90e8\u5206\u3002\u6b64\u5916\u8fd8\u5305\u62ec\u9ad8\u6e17\u900f\u6cbb\u7597\u3001\u5df4\u6bd4\u59a5\u7c7b\u836f\u7269\u6cbb\u7597\u3001\u8111\u810a\u6db2\u5f15\u6d41\u3001\u53bb\u9aa8\u74e3\u51cf\u538b\u672f\u7b49\u3002\u75bc\u75db\u3001\u8e81\u52a8\u3001\u4eba\u673a\u5931\u8c03\u7b49\u60c5\u51b5\u53ef\u80fd\u5f15\u8d77ICP\u5347\u9ad8\uff0c\u8fd9\u5747\u662f\u9547\u75db\u9547\u9759\u7684\u9002\u5e94\u8bc1\u3002\u56e0\u6b64\uff0c\u5982\u4f55\u6070\u5f53\u5730\u5b9e\u65bd\u9547\u75db\u9547\u9759\uff08\u5305\u62ec\u836f\u7269\u9009\u62e9\u3001\u9547\u9759\u6df1\u5ea6\u7b49\uff09\u662f\u63a7\u5236IH\u7684\u5173\u952e\u63aa\u65bd\u4e4b\u4e00\u30022017\u5e74\u7f8e\u56fd\u7b2c4\u7248sTBI\u7ba1\u7406\u6307\u5357\u548c2019\u5e74SIBICC\u5747\u5c06\u9547\u75db\u9547\u9759\u6cbb\u7597\u7eb3\u5165\u4e86ICP\u7ba1\u7406\u7684\u57fa\u7840\u6cbb\u7597<sup>[13\uff0c14]<\/sup>\u3002\u503c\u5f97\u6ce8\u610f\u7684\u662f\uff0c\u5bf9\u4e8eIH\u5408\u5e76\u8840\u6d41\u52a8\u529b\u5b66\u4e0d\u7a33\u5b9a\u7684\u60a3\u8005\uff0c\u6216\u60a3\u8005\u5904\u4e8e\u8bca\u65ad\u5c1a\u4e0d\u660e\u786e\u7684\u9636\u6bb5\u65f6\uff0c\u9547\u75db\u9547\u9759\u6cbb\u7597\u53ef\u80fd\u52a0\u91cd\u6216\u63a9\u76d6\u75c5\u60c5\uff0c\u6b64\u65f6IH\u7684\u6cbb\u7597\u7b56\u7565\u5e94\u6743\u8861\u5229\u5f0a\u8fdb\u884c\u5206\u5c42\u7efc\u5408\u7ba1\u7406\u3002<\/p>\n<p>\u8bc1\u636e\u603b\u7ed3\uff1a\u5173\u4e8e\u9547\u75db\u836f\u7269\u7684\u7279\u6027\uff0cWiener\u7b49<sup>[15]<\/sup>\u7684\u4e00\u9879\u7cfb\u7edf\u8bc4\u4ef7\u603b\u7ed3\u4e86\u963f\u7247\u7c7b\u836f\u7269\u5bf9\u6025\u6027\u671f\u9885\u8111\u635f\u4f24\uff08traumatic brain injury\uff0cTBI\uff09\u8111\u751f\u7406\u5b66\u7684\u5f71\u54cd\uff0c\u963f\u7247\u7c7b\u836f\u7269\u5728\u9547\u75db\u548c\u9547\u9759\u65b9\u9762\u662f\u6709\u76ca\u7684\uff0c\u4f46\u7814\u7a76\u7ed3\u679c\u5b58\u5728\u8f83\u5927\u5f02\u8d28\u6027\u3002\u603b\u4f53\u6765\u8bf4\uff0c\u9759\u8109\u8f93\u6ce8\u963f\u7247\u7c7b\u836f\u7269\u5bf9ICP\u53ca\u8111\u704c\u6ce8\u538b\uff08cerebral perfusion pressure\uff0cCPP\uff09\u65e0\u660e\u663e\u5f71\u54cd\u3002Roberts\u7b49<sup>[16]<\/sup>\u7684\u4e00\u9879\u7cfb\u7edf\u8bc4\u4ef7\u63d0\u793a\u5927\u5242\u91cf\u963f\u7247\u7c7b\u836f\u7269\u5bf9sTBI\u60a3\u8005ICP\u548cCPP\u5177\u6709\u6f5c\u5728\u7684\u98ce\u9669\uff0c\u800c\u4e0d\u540c\u9547\u9759\u836f\u7269\u4e4b\u95f4\u5bf9\u8111\u751f\u7406\u5b66\u53c2\u6570\u7684\u5f71\u54cd\u65e0\u663e\u8457\u5dee\u5f02\u3002Gu\u7b49<sup>[17]<\/sup>\u7684\u4e00\u9879\u7cfb\u7edf\u8bc4\u4ef7\u7eb3\u5165\u4e864\u9879\u7814\u7a76\uff0c\u53d1\u73b0\u4e19\u6cca\u915a\u4e0e\u54aa\u8fbe\u5511\u4ed1\u5bf9sTBI\u60a3\u8005\u7684\u683c\u62c9\u65af\u54e5\u660f\u8ff7\u8bc4\u5206\uff08Glasgow coma scale\uff0cGCS\uff09\u3001\u75c5\u6b7b\u7387\u3001ICP\u548cCPP\u6709\u76f8\u4f3c\u5f71\u54cd\uff0c\u4f46\u4e24\u8005\u4e4b\u95f4\u65e0\u663e\u8457\u5dee\u5f02\u3002\u53e6\u5916\uff0c\u53f3\u7f8e\u6258\u54aa\u5b9a\u4e5f\u88ab\u5e7f\u6cdb\u5e94\u7528\u4e8e\u795e\u7ecf\u91cd\u75c7\u60a3\u8005\u3002Tran\u7b49<sup>[18]<\/sup>\u7684\u7cfb\u7edf\u8bc4\u4ef7\u7eb3\u5165\u4e867\u9879\u7814\u7a76\uff0c\u8bc4\u4f30\u4e86\u03b1<sub>2<\/sub>\u53d7\u4f53\u6fc0\u52a8\u5242\u5728\u63a5\u53d7\u673a\u68b0\u901a\u6c14\u7684NCU\u60a3\u8005\u4e2d\u7684\u5b89\u5168\u6027\u548c\u6709\u6548\u6027\uff0c\u7ed3\u679c\u8868\u660e\uff0c\u53f3\u7f8e\u6258\u54aa\u5b9a\u53ef\u7ef4\u6301\u76ee\u6807\u9547\u9759\u6c34\u5e73\uff0c\u540c\u65f6\u53ef\u51cf\u5c11\u5176\u4ed6\u8f85\u52a9\u9547\u9759\u5242\u548c\u9547\u75db\u5242\u7684\u9700\u6c42\uff0c\u4e14\u672a\u5f15\u8d77\u8840\u6d41\u52a8\u529b\u5b66\u969c\u788d\u3002\u5bf9\u4e8e\u5df4\u6bd4\u59a5\u7c7b\u836f\u7269\uff0c\u4e00\u9879RCT\u7814\u7a76\u7eb3\u5165\u4e8640\u4f8bNCU\u60a3\u8005\uff0c\u7ed3\u679c\u663e\u793a\uff0c\u4e19\u6cca\u915a\u548c\u4f4e\u5242\u91cf\u786b\u55b7\u59a5\u94a0\u53ef\u964d\u4f4eICP\uff0c\u4f46\u4e24\u8005\u4e4b\u95f4\u65e0\u663e\u8457\u5dee\u5f02<sup>[19]<\/sup>\u3002<\/p>\n<p>\u63a8\u8350\u610f\u89c13\uff1a\u9547\u75db\u9547\u9759\u6cbb\u7597\u662f\u795e\u7ecf\u91cd\u75c7\u60a3\u8005\u51fa\u73b0IH\u65f6\u7684\u57fa\u7840\u6cbb\u7597\u3002\uff08\u5171\u8bc6\u5ea6\uff1a100%\uff1b36\/36\uff09<\/p>\n<p>\u4e34\u5e8a\u95ee\u98983\uff1a\u795e\u7ecf\u91cd\u75c7\u60a3\u8005\u8fdb\u884cTTM\u65f6\u662f\u5426\u5e94\u8fdb\u884c\u9547\u75db\u9547\u9759\u6cbb\u7597\uff1f<\/p>\n<p>\u80cc\u666f\uff1aTTM\u5e38\u7528\u4e8e\u5fc3\u640f\u9aa4\u505c\u540e\u795e\u7ecf\u7cfb\u7edf\u635f\u4f24\u3001sTBI\u3001\u91cd\u75c7\u86db\u7f51\u819c\u4e0b\u8154\u51fa\u8840\uff08subarachnoid hemorrhage\uff0cSAH\uff09\u3001\u5927\u9762\u79ef\u8111\u6897\u6b7b\u4ee5\u53ca\u766b\u75eb\u6301\u7eed\u72b6\u6001\u7b49\u60c5\u51b5\u4ee5\u9884\u9632\u7ee7\u53d1\u6027\u8111\u635f\u4f24\uff0c\u6cbb\u7597RIH\u3002\u5728TTM\u8fc7\u7a0b\u4e2d\uff0c\u9547\u75db\u9547\u9759\u6cbb\u7597\u53d1\u6325\u4e86\u91cd\u8981\u4f5c\u7528\uff0c\u5176\u4e3b\u8981\u76ee\u7684\u5305\u62ec\u63a7\u5236ICP\u3001\u9884\u9632\u5bd2\u6218\u3001\u6539\u5584\u4eba\u673a\u5931\u8c03\u3001\u51cf\u8f7b\u5e94\u6fc0\u53cd\u5e94\u3001\u964d\u4f4e\u6c27\u8017\u7b49<sup>[20]<\/sup>\u3002<\/p>\n<p>\u8bc1\u636e\u603b\u7ed3\uff1a\u5173\u4e8eTTM\u7684\u5927\u591a\u6570\u7814\u7a76\u5728\u6cbb\u7597\u8fc7\u7a0b\u4e2d\u6574\u5408\u4e86\u9547\u75db\u9547\u9759\u6cbb\u7597\u30022010\u5e74\uff0cChamorro\u7b49<sup>[21]<\/sup>\u7684\u4e00\u9879\u7cfb\u7edf\u8bc4\u4ef7\u7eb3\u5165\u4e8644\u9879\u7814\u7a76\uff0c\u62a5\u544a\u4e861997\u81f32009\u5e74\u4e0d\u540c\u56fd\u5bb6\u768468\u4e2aICU\u5e94\u7528\u9547\u75db\u9547\u9759\u836f\u7269\u548c\u795e\u7ecf\u808c\u8089\u963b\u6ede\u836f\u7269\u8fdb\u884c\u6cbb\u7597\u6027\u4f4e\u6e29\uff08therapeutic hypothermia\uff0cTH\uff09\u6cbb\u7597\u5fc3\u640f\u9aa4\u505c\u540e\u660f\u8ff7\u60a3\u8005\u7684\u65b9\u6848\u30022019\u5e74\uff0cChen\u7b49<sup>[22]<\/sup>\u7684\u4e00\u9879\u835f\u8403\u5206\u6790\u7eb3\u516523\u9879\u7814\u7a76\uff0c\u805a\u7126\u5728TBI\u60a3\u8005TH\u5bf9\u75c5\u6b7b\u7387\u7684\u5f71\u54cd\uff0c\u5176\u4e2d\u4e5f\u4e0d\u4e4f\u6cbb\u7597\u8fc7\u7a0b\u4e2d\u9547\u75db\u9547\u9759\u65b9\u6848\u7684\u62a5\u9053\u3002Andrews\u7b49<sup>[23]<\/sup>\u7684\u4e00\u9879RCT\u7814\u7a76TH\u5bf9sTBI\u60a3\u8005\u9884\u540e\u7684\u5f71\u54cd\uff0c\u5176\u4e2d\u9547\u75db\u9547\u9759\u6cbb\u7597\u65b9\u6848\u66f4\u591a\u7528\u4e8e\u5bd2\u6218\u7684\u5904\u7406\u30022023\u5e74\u7684\u4e00\u9879\u56fd\u9645\u591a\u4e2d\u5fc3TTM\u8bd5\u9a8c\u5206\u6790\u4e8618\u4e2a\u4e2d\u5fc3\u7684614\u4f8b\u5fc3\u80ba\u590d\u82cf\uff08cardiopulmonary resuscitation\uff0cCPR\uff09\u540e\u60a3\u8005\uff0c\u53d1\u73b0\u8be5\u7814\u7a76\u4e2d\u82ac\u592a\u5c3c\uff0851%\uff09\u548c\u4e19\u6cca\u915a\uff0870%\uff09\u5206\u522b\u662f\u6700\u5e38\u7528\u7684\u9547\u75db\u3001\u9547\u9759\u836f\u7269<sup>[24]<\/sup>\u3002\u603b\u4f53\u4e0a\uff0cTTM\u8fc7\u7a0b\u4e2d\u9547\u75db\u9547\u9759\u65b9\u6848\u5728\u4e0d\u540c\u7814\u7a76\u4e2d\u5dee\u5f02\u8f83\u5927\u3002<\/p>\n<p>\u63a8\u8350\u610f\u89c14\uff1a\u795e\u7ecf\u91cd\u75c7\u60a3\u8005\u8fdb\u884cTTM\u65f6\u53ef\u7ed9\u4e88\u9547\u75db\u9547\u9759\u6cbb\u7597\u3002\uff08\u5171\u8bc6\u5ea6\uff1a100%\uff1b36\/36\uff09<\/p>\n<p>\u4e66\u7c4d\u5e7f\u544a<\/p>\n<p>4\u3000\u795e\u7ecf\u91cd\u75c7\u60a3\u8005\u5728\u9547\u75db\u9547\u9759\u6cbb\u7597\u8fc7\u7a0b\u4e2d\u7684\u76d1\u6d4b<\/p>\n<p>\u4e34\u5e8a\u95ee\u98984\uff1a\u795e\u7ecf\u91cd\u75c7\u60a3\u8005\u662f\u5426\u5e94\u8fdb\u884c\u75bc\u75db\u8bc4\u4f30\uff1f<\/p>\n<p>\u4e34\u5e8a\u95ee\u98985\uff1a\u795e\u7ecf\u91cd\u75c7\u60a3\u8005\u7684\u75bc\u75db\u8bc4\u4f30\u5de5\u5177\u5e94\u5982\u4f55\u9009\u62e9\uff1f<\/p>\n<p>\u80cc\u666f\uff1a\u795e\u7ecf\u91cd\u75c7\u60a3\u8005\u7ecf\u5386\u7684\u75bc\u75db\u53ef\u80fd\u8fdc\u8d85\u9884\u6599\u3002\u4e0d\u540c\u7a0b\u5ea6\u7684\u795e\u7ecf\u529f\u80fd\u7f3a\u9677\u53ef\u80fd\u5e72\u6270\u5bf9\u8be5\u60a3\u8005\u7fa4\u4f53\u7684\u75bc\u75db\u548c\u8e81\u52a8\u7684\u8bc4\u4f30\uff0c\u4f46\u533b\u62a4\u4eba\u5458\u5bf9\u8fd9\u4e2a\u95ee\u9898\u7684\u8ba4\u77e5\u5bfc\u81f4\u7684\u8bc4\u4f30\u4e0d\u8db3\u53ef\u80fd\u5f71\u54cd\u66f4\u5927\u3002\u4e8b\u5b9e\u4e0a\uff0c70%\u7684\u795e\u7ecf\u91cd\u75c7\u60a3\u8005\u80fd\u4f7f\u7528\u75bc\u75db\u6570\u5b57\u8bc4\u4ef7\u91cf\u8868\uff08numerical rating scale\uff0cNRS\uff09\u3001\u957f\u6d77\u75db\u5c3a\u7b49\u62a5\u544a\u81ea\u5df1\u7684\u75bc\u75db\u7a0b\u5ea6\uff0c\u4e0e\u6b64\u540c\u65f6\uff0c\u4e34\u5e8a\u533b\u62a4\u4eba\u5458\u4e5f\u53ef\u901a\u8fc7\u884c\u4e3a\u75bc\u75db\u91cf\u8868\uff08behavior pain scale\uff0cBPS\uff09\u7b49\u5de5\u5177\u8bc4\u4f30\u60a3\u8005\u7684\u75bc\u75db\u3002\u5bf9\u4e8e\u5b58\u5728\u610f\u8bc6\u969c\u788d\u3001\u6216\u5904\u4e8e\u9547\u75db\u9547\u9759\u72b6\u6001\u800c\u65e0\u6cd5\u901a\u8fc7\u8bed\u8a00\u7b49\u65b9\u5f0f\u6c9f\u901a\u7684\u795e\u7ecf\u91cd\u75c7\u60a3\u8005\uff0c\u5728\u75bc\u75db\u8bc4\u4f30\u65f6\u5177\u6709\u4e00\u5b9a\u7684\u96be\u5ea6\u3002\u9664\u60a3\u8005\u4e3b\u8bc9\u5916\uff0c\u5176\u4ed6\u6307\u6807\u5982\u75bc\u75db\u523a\u6fc0\u524d\u540e\u5fc3\u7387\u7684\u52a8\u6001\u53d8\u5316\u4e5f\u53ef\u80fd\u63d0\u793a\u75bc\u75db\u7684\u5b58\u5728\u3002\u76ee\u524d\u666e\u904d\u5e94\u7528\u7684\u75bc\u75db\u8bc4\u4f30\u91cf\u8868\u53ef\u80fd\u4e0d\u80fd\u4ee3\u8868\u795e\u7ecf\u91cd\u75c7\u60a3\u8005\u7fa4\u4f53\u6240\u8868\u8fbe\u7684\u884c\u4e3a\u53cd\u5e94\uff0c\u4f8b\u5982TBI\u60a3\u8005\u8868\u8fbe\u75bc\u75db\u7684\u65b9\u5f0f\u6709\u53ef\u80fd\u662f\u975e\u5178\u578b\u7684\uff0c\u5982\u8138\u90e8\u6f6e\u7ea2\u3001\u7a81\u7136\u7741\u773c\u3001\u6d41\u6cea\u548c\u56db\u80a2\u5c48\u4f38\u7b49\u3002\u56e0\u6b64\uff0c\u76ee\u524d\u5bf9\u795e\u7ecf\u91cd\u75c7\u60a3\u8005\u7684\u75bc\u75db\u8bc4\u4f30\u4ecd\u5177\u6709\u6311\u6218\u6027\u3002<\/p>\n<p>\u8bc1\u636e\u603b\u7ed3\uff1a\u8fd1\u5e74\u6765\u6709\u5173NCU\u60a3\u8005\u75bc\u75db\u7684\u8bc4\u4f30\u4e0e\u76d1\u6d4b\uff0c\u56fd\u5916\u9c9c\u6709\u7cfb\u7edf\u8bc4\u4ef7\u7684\u62a5\u9053\uff0c\u591a\u6570\u4e3a\u89c2\u5bdf\u6027\u7814\u7a76\u3002Suksompong\u7b49<sup>[25]<\/sup>\u7814\u7a76\u53d1\u73b0\uff0c\u5f00\u9885\u672f\u540e\u4e2d\u5ea6\u81f3\u91cd\u5ea6\u75bc\u75db\u7684\u53d1\u751f\u7387\u9ad8\u8fbe75%\uff0c\u5e76\u4e14\u51e0\u4e4e\u6240\u6709\u60a3\u8005\u672f\u540e\u90fd\u63a5\u53d7\u4e86\u9759\u8109\u6ce8\u5c04\u963f\u7247\u7c7b\u836f\u7269\u548c\u53e3\u670d\u5bf9\u4e59\u9170\u6c28\u57fa\u915a\u8fdb\u884c\u9547\u75db\u6cbb\u7597\u3002Boitor\u7b49<sup>[26]<\/sup>\u9a8c\u8bc1\u4e86\u751f\u547d\u4f53\u5f81\u5728\u6210\u4ebasTBI\u60a3\u8005\u75bc\u75db\u68c0\u6d4b\u4e2d\u7684\u5e94\u7528\uff0c\u53d1\u73b0\u81f4\u75db\u6027\u64cd\u4f5c\u524d\u540e\u5fc3\u7387\u7684\u52a8\u6001\u53d8\u5316\u53ef\u80fd\u63d0\u793a\u75bc\u75db\u7684\u5b58\u5728\uff0c\u5229\u7528\u9762\u90e8\u75bc\u75db\u62a5\u544a\u8868\uff08faces pain thermometer\uff0cFPT\uff09\u53d1\u73b0\u6536\u7f29\u538b\u5347\u9ad8\u4e0e\u75bc\u75db\u5448\u6b63\u76f8\u5173\uff0c\u7136\u800c\u751f\u547d\u4f53\u5f81\u7684\u53d8\u5316\u5e76\u4e0d\u5177\u6709\u7279\u5f02\u6027\u3002\u4e00\u9879RCT\u7814\u7a76\u5bf9\u9885\u5185\u80bf\u7624\u5207\u9664\u672f\u540e\u60a3\u8005\u91c7\u53d6\u89c6\u89c9\u6a21\u62df\u8bc4\u5206\u6cd5\uff08visual analogue scale\uff0cVAS\uff09\u8fdb\u884c\u75bc\u75db\u8bc4\u4f30<sup>[27]<\/sup>\u3002Kim\u7b49<sup>[28]<\/sup>\u5bf9\u9885\u5185\u80bf\u7624\u5f00\u9885\u672f\u540e\u60a3\u8005\u4e5f\u91c7\u7528\u4e86VAS\u8bc4\u4f30\u672f\u540e\u75bc\u75db\uff0c\u7136\u800c\u8be5\u7814\u7a76\u6392\u9664\u4e86\u672f\u540e\u65b0\u53d1\u795e\u7ecf\u529f\u80fd\u969c\u788d\u6216\u7531\u4e8e\u610f\u8bc6\u6c34\u5e73\u964d\u4f4e\u800c\u65e0\u6cd5\u8bc4\u4f30\u75bc\u75db\u7684\u60a3\u8005\u3002Ribeiro\u7b49<sup>[29]<\/sup>\u53d1\u73b0\uff0c\u5bf9TBI\u60a3\u8005\u8fdb\u884c\u81f4\u75db\u6027\u64cd\u4f5c\uff08\u5438\u75f0\uff09\u65f6\uff0c\u5176\u5fc3\u7387\u3001\u8840\u538b\u660e\u663e\u589e\u52a0\uff0c\u540c\u65f6\u9a8c\u8bc1\u4e86\u5df4\u897f\u7248BPS\u8bc4\u4f30\u75bc\u75db\u7684\u6709\u6548\u6027\u548c\u53ef\u9760\u6027\u3002Joffe\u7b49<sup>[30]<\/sup>\u53d1\u73b0\uff0c\u5bf9\u8111\u635f\u4f24\u60a3\u8005\u91c7\u53d6\u81f4\u75db\u6027\u64cd\u4f5c\uff08\u7ffb\u8eab\uff09\u65f6\uff0c\u5176\u91cd\u75c7\u76d1\u62a4\u75bc\u75db\u89c2\u5bdf\u5de5\u5177\uff08critical-care pain observation tool\uff0cCPOT\uff09\u8bc4\u5206\u66f4\u9ad8\uff0c\u5e76\u4e14\u4e0eFPT\u660e\u663e\u76f8\u5173\uff0c\u63d0\u793aCPOT\u5728\u8111\u635f\u4f24\u7fa4\u4f53\u4e2d\u5177\u6709\u6709\u6548\u6027\u548c\u53ef\u9760\u6027\u3002\u4e00\u9879\u56fd\u9645\u591a\u4e2d\u5fc3\u7814\u7a76\u9a8c\u8bc1\u4e86CPOT-Neuro\u5bf9\u8111\u635f\u4f24\u60a3\u8005\u75bc\u75db\u8bc4\u4f30\u7684\u6709\u6548\u6027<sup>[31]<\/sup>\u30023\u9879\u89c2\u5bdf\u6027\u7814\u7a76\u663e\u793a\uff0c\u5bf9TBI\u60a3\u8005\u91c7\u53d6\u81f4\u75db\u6027\u64cd\u4f5c\u65f6\u75bc\u75db\u884c\u4e3a\u660e\u663e\u589e\u52a0\uff0c\u5e38\u89c2\u5bdf\u5230\u7684\u75bc\u75db\u884c\u4e3a\u5305\u62ec\u9762\u90e8\u8868\u60c5\u63d0\u808c\u6536\u7f29\u3001\u7a81\u7136\u7741\u773c\u3001\u76b1\u7709\u3001\u5634\u5507\u53d8\u5316\u3001\u56db\u80a2\u6d3b\u52a8\u3001\u9888\u90e8\u50f5\u786c\u3001\u53f9\u6c14\u6216\u547b\u541f\uff0c\u751a\u81f3\u6709\u4e00\u4e9b\u975e\u5178\u578b\u884c\u4e3a<sup>[32\uff0c33\uff0c34]<\/sup>\u3002Topolovec-Vranic\u7b49<sup>[35\uff0c36]<\/sup>\u4e5f\u5728\u521b\u4f24\u548c\u795e\u7ecf\u5916\u79d1\u91cd\u75c7\u75c5\u623f\u9a8c\u8bc1\u4e86\u4fee\u8ba2\u7684\u6210\u4eba\u975e\u8bed\u8a00\u75bc\u75db\u91cf\u8868\uff08the revised adult nonverbal pain scale\uff0cNVPS-R\uff09\u548cCPOT\u7684\u53ef\u884c\u6027\u3002\u5bf9\u4e8e\u9547\u9759\u72b6\u6001\u548c\u610f\u8bc6\u969c\u788d\u60a3\u8005\uff0c\u75bc\u75db\u884c\u4e3a\u53ef\u80fd\u8868\u73b0\u4e0d\u660e\u663e\uff0cMartineau-Lessard\u7b49<sup>[37]<\/sup>\u7684\u7814\u7a76\u663e\u793a\uff0c\u77b3\u5b54\u5bf9\u5149\u53cd\u5c04\uff08pupil light reflex\uff0cPLR\uff09\u53ef\u7528\u4e8e\u5904\u4e8e\u9547\u9759\u72b6\u6001\u7684TBI\u60a3\u8005\u5728\u8fdb\u884c\u81f4\u75db\u6027\u64cd\u4f5c\u524d\u7684\u75bc\u75db\u8bc4\u4f30\u3002\u56fd\u5185\u4e00\u9879\u835f\u8403\u5206\u6790\u663e\u793a\uff0cCPOT\u5bf9\u4e8e\u64cd\u4f5c\u6027\u75bc\u75db\u5177\u6709\u8f83\u597d\u7684\u5224\u522b\u6548\u5ea6<sup>[38]<\/sup>\u3002\u4e00\u9879\u89c2\u5bdf\u6027\u7814\u7a76\u663e\u793a\uff0c\u5bf9\u4e8e\u9885\u8111\u80bf\u7624\u5f00\u9885\u672f\u540e\u4e14\u884c\u673a\u68b0\u901a\u6c14\u7684\u60a3\u8005\uff0c\u5e94\u7528CPOT\u8fdb\u884c\u75bc\u75db\u8bc4\u4f30\u5177\u6709\u8f83\u597d\u7684\u6709\u6548\u6027\u548c\u53ef\u9760\u6027\uff0c\u7279\u522b\u662f\u5b58\u5728\u8868\u8fbe\u969c\u788d\u7684\u60a3\u8005\u4e2d\u533a\u8fa8\u6548\u5ea6\u826f\u597d<sup>[39]<\/sup>\u3002\u53e6\u59162\u9879\u89c2\u5bdf\u6027\u7814\u7a76\u5206\u522b\u663e\u793a\u51faCPOT\u5bf9\u795e\u7ecf\u5916\u79d1\u5f00\u9885\u672f\u540e\u60a3\u8005\u5728\u81f4\u75db\u6027\u64cd\u4f5c\u548c\u9759\u606f\u75db\u8bc4\u4f30\u65f6\u7684\u826f\u597d\u4fe1\u5ea6\u4e0e\u6548\u5ea6<sup>[40\uff0c41]<\/sup>\u3002\u5bf9\u4e8e\u690d\u7269\u72b6\u6001\u6216\u6700\u5c0f\u610f\u8bc6\u72b6\u6001\u7684\u60a3\u8005\uff0c\u4e00\u9879\u89c2\u5bdf\u6027\u7814\u7a76\u663e\u793a\uff0c\u6539\u826f\u7684\u4f24\u5bb3\u6027\u75bc\u75db\u523a\u6fc0\uff08nociception coma scale-revised\uff0cNCS-R\uff09\u5728\u8fd9\u4e9b\u60a3\u8005\u7684\u75bc\u75db\u8bc4\u4f30\u65b9\u9762\u5177\u6709\u826f\u597d\u7684\u654f\u611f\u6027<sup>[42]<\/sup>\u3002<\/p>\n<p>\u4e66\u7c4d\u5e7f\u544a<\/p>\n<p>\u63a8\u8350\u610f\u89c15\uff1a\u795e\u7ecf\u91cd\u75c7\u60a3\u8005\u5e94\u8fdb\u884c\u75bc\u75db\u8bc4\u4f30\u3002\uff08\u5171\u8bc6\u5ea6\uff1a100%\uff1b36\/36\uff09<\/p>\n<p>\u63a8\u8350\u610f\u89c16\uff1a\u5e94\u57fa\u4e8e\u795e\u7ecf\u91cd\u75c7\u60a3\u8005\u7684\u610f\u8bc6\u6c34\u5e73\u4ee5\u53ca\u8bed\u8a00\u529f\u80fd\u9009\u62e9\u5408\u9002\u7684\u75bc\u75db\u8bc4\u4f30\u5de5\u5177\u3002\uff08\u5171\u8bc6\u5ea6\uff1a97.2%\uff1b35\/36\uff09<\/p>\n<p>\u63a8\u8350\u610f\u89c17\uff1a\u5bf9\u4e8e\u80fd\u591f\u81ea\u6211\u8bc4\u4f30\u7684\u795e\u7ecf\u91cd\u75c7\u60a3\u8005\uff0c\u53ef\u4f9b\u9009\u62e9\u7684\u5de5\u5177\u5305\u62ecNRS\u3001VAS\u3001\u957f\u6d77\u75db\u5c3a\uff1b\u5bf9\u4e8e\u65e0\u6cd5\u51c6\u786e\u81ea\u6211\u8bc4\u4f30\u7684\u795e\u7ecf\u91cd\u75c7\u60a3\u8005\uff0c\u53ef\u4f9b\u9009\u62e9\u7684\u75bc\u75db\u8bc4\u4f30\u5de5\u5177\u5305\u62ec\u9762\u90e8\u8868\u60c5\u8bc4\u5206\u6cd5\u3001BPS\u3001CPOT\u3001NVPS-R\u3001PLR\u7b49\u3002\uff08\u5171\u8bc6\u5ea6\uff1a97.2%\uff1b35\/36\uff09<\/p>\n<p>\u63a8\u8350\u610f\u89c18\uff1a\u4e0d\u63a8\u8350\u5355\u72ec\u4ee5\u751f\u547d\u4f53\u5f81\u53d8\u5316\u4f5c\u4e3a\u75bc\u75db\u7684\u8bc4\u4f30\u65b9\u6cd5\uff0c\u4f46\u53ef\u4f5c\u4e3a\u8f85\u52a9\u624b\u6bb5\uff0c\u7528\u4e8e\u53d1\u73b0\u6f5c\u5728\u75bc\u75db\u3002\uff08\u5171\u8bc6\u5ea6\uff1a100%\uff1b36\/36\uff09<\/p>\n<p>\u4e34\u5e8a\u95ee\u98986\uff1a\u795e\u7ecf\u91cd\u75c7\u60a3\u8005\u662f\u5426\u5e94\u8fdb\u884c\u9547\u9759\u8bc4\u4f30\uff1f<\/p>\n<p>\u4e34\u5e8a\u95ee\u98987\uff1a\u795e\u7ecf\u91cd\u75c7\u60a3\u8005\u7684\u9547\u9759\u8bc4\u4f30\u65b9\u6cd5\u5e94\u5982\u4f55\u9009\u62e9\uff1f<\/p>\n<p>\u80cc\u666f\uff1a\u795e\u7ecf\u91cd\u75c7\u60a3\u8005\u7684\u9547\u9759\u8bc4\u4f30\u4e5f\u662f\u4e00\u4e2a\u590d\u6742\u7684\u95ee\u9898\u3002\u65e0\u8bba\u8e81\u52a8\uff0c\u8fd8\u662f\u8fc7\u4e8e\u5b89\u9759\uff0c\u90fd\u53ef\u80fd\u662f\u6f5c\u5728\u7684\u795e\u7ecf\u7cfb\u7edf\u75c5\u53d8\u7684\u4e34\u5e8a\u8868\u73b0\uff0c\u800c\u975e\u5355\u7eaf\u9547\u9759\u4e0d\u8db3\u6216\u6df1\u9547\u9759\u5bfc\u81f4\u7684\u3002\u6b64\u5916\uff0c\u8e81\u52a8\u4e5f\u4e0d\u4ec5\u662fIH\u7684\u5916\u5728\u8868\u73b0\uff0c\u4e5f\u53ef\u80fd\u4f1a\u5f15\u8d77ICP\u5347\u9ad8\uff0c\u5f71\u54cd\u60a3\u8005\u9884\u540e\u3002\u5bf9\u4e8e\u7ed9\u4e88\u57fa\u7840\u75bc\u75db\u6cbb\u7597\u540e\u4ecd\u5b58\u5728\u8e81\u52a8\u7684\u60a3\u8005\uff0c\u5e94\u91c7\u53d6\u8054\u5408\u9547\u9759\u6cbb\u7597\u8fbe\u5230\u51cf\u5c11\u8e81\u52a8\u3001\u964d\u4f4eICP\u7b49\u76ee\u7684\u3002\u5bf9\u4e8e\u9547\u9759\u6df1\u5ea6\u7684\u8bc4\u4f30\uff0cICU\u5e38\u7528\u7684\u9547\u9759\u8bc4\u4f30\u91cf\u8868\u6709Richmond\u8e81\u52a8-\u9547\u9759\u8bc4\u5206\uff08Richmond agitation-sedation scale\uff0cRASS\uff09\u3001Riker\u9547\u9759-\u8e81\u52a8\u8bc4\u5206\uff08sedation-agitation scale\uff0cSAS\uff09\u3001Ramsay\u8bc4\u5206\u7b49\u3002\u7136\u800c\u5bf9\u4e8e\u795e\u7ecf\u91cd\u75c7\u60a3\u8005\u9547\u9759\u8bc4\u4f30\u5de5\u5177\u7684\u9009\u62e9\u503c\u5f97\u8fdb\u4e00\u6b65\u7814\u7a76\u3002\u5bf9\u4e8e\u6301\u7eed\u660f\u8ff7\uff08GCS\u22648\u5206\uff09\u7684\u60a3\u8005\uff0c\u5c3d\u7ba1RASS\u7b49\u8bc4\u4f30\u91cf\u8868\u4ecd\u53ef\u5e94\u7528\uff0c\u4f46\u5206\u503c\u7f3a\u4e4f\u52a8\u6001\u53d8\u5316\uff0c\u56e0\u6b64\u4ef7\u503c\u6709\u9650\u3002\u9664\u4e3b\u89c2\u8bc4\u4f30\u5de5\u5177\u5916\uff0c\u4e00\u4e9b\u5ba2\u89c2\u76d1\u6d4b\u662f\u5426\u53ef\u4ee5\u4f5c\u4e3a\u8bc4\u4f30\u9547\u9759\u6c34\u5e73\u7684\u8f85\u52a9\u624b\u6bb5\u8054\u5408\u5e94\u7528\u540c\u6837\u503c\u5f97\u63a2\u8ba8\u3002<\/p>\n<p>\u8bc1\u636e\u603b\u7ed3\uff1a\u8fd1\u5e74\u6765\u5c1a\u7f3a\u4e4f\u5bf9NCU\u60a3\u8005\u8e81\u52a8\/\u9547\u9759\u7684\u7cfb\u7edf\u8bc4\u4ef7\u3002\u7814\u7a76\u62a5\u9053\uff0c\u65e0\u8bba\u662f\u9885\u8111\u80bf\u7624\u5f00\u9885\u672f\u540e\u60a3\u8005\u8fd8\u662fTBI\u60a3\u8005\uff0c\u8e81\u52a8\u90fd\u662f\u4e00\u79cd\u5e38\u89c1\u5e76\u53d1\u75c7\uff0c\u5e76\u4e14\u4e0e\u610f\u5916\u62d4\u7ba1\u4ee5\u53ca\u4e0d\u826f\u9884\u540e\u76f8\u5173<sup>[43\uff0c44]<\/sup>\u3002\u5371\u91cd\u75c7\u60a3\u8005\u5e38\u7528\u7684\u9547\u9759\u8bc4\u4f30\u5de5\u5177\u4e5f\u5e38\u5e94\u7528\u4e8eNCU\u60a3\u8005\uff0c\u4f46\u9c9c\u89c1\u6709\u5173\u4fe1\u5ea6\u548c\u6548\u5ea6\u7684\u62a5\u9053\u3002\u5f53\u60a3\u8005\u5904\u4e8e\u9547\u9759\u6216\u63d2\u7ba1\u72b6\u6001\uff0c\u6216\u5176\u4ed6\u65e0\u6cd5\u51c6\u786e\u8bc4\u4f30\u9547\u9759\u6c34\u5e73\u7684\u60c5\u51b5\u4e0b\uff0c\u9547\u9759\u6df1\u5ea6\u7684\u5ba2\u89c2\u76d1\u6d4b\u624b\u6bb5\u4e3b\u8981\u662f\u91cf\u5316\u8111\u7535\u56fe\uff08quantitative electroencephalography\uff0cqEEG\uff09\u76d1\u6d4b\u6280\u672f\uff0c\u5305\u62ec\u8111\u7535\u53cc\u9891\u6307\u6570\uff08bispectral index\uff0cBIS\uff09\u3001Narcotrend\u6307\u6570\uff08narcotrend index\uff0cNI\uff09\u3001\u8111\u72b6\u6001\u6307\u6570\uff08cerebral state index\uff0cCSI\uff09\u3001\u542c\u89c9\u8bf1\u53d1\u7535\u4f4d\uff08auditory evoked potential\uff0cAEP\uff09\u548c\u71b5\u6307\u6570\uff08stateentropy\uff0cSE\uff09\u3002\u4e00\u9879\u57fa\u4e8e\u8111\u7535\u56fe\uff08electroencephalography\uff0cEEG\uff09\u76d1\u6d4b\u6307\u5bfc\u91cd\u75c7\u6210\u4eba\u60a3\u8005\u7684\u9547\u9759\u6cbb\u7597\u5171\u8bc6\u8ba4\u4e3a\u989d\u53f6\u52a0\u5de5\u8111\u7535\u56fe\uff08processed electroencephalography\uff0cpEEG\uff09\u8db3\u4ee5\u76d1\u6d4b\u9547\u9759\u6c34\u5e73\uff0c\u5c24\u5176\u662f\u5728\u63a5\u53d7\u795e\u7ecf\u808c\u8089\u963b\u6ede\u836f\u7269\u800c\u65e0\u6cd5\u83b7\u5f97\u4e3b\u89c2\u9547\u9759\u8bc4\u4f30\u7684\u60a3\u8005\u4e2d\u3002pEEG\u662f\u4e00\u9879\u7279\u5b9a\u76d1\u6d4b\u6280\u672f\uff0c\u9700\u8981\u7ecf\u8fc7\u7279\u5b9a\u57f9\u8bad\u65b9\u53ef\u5b9e\u65bd<sup>[45]<\/sup>\u3002\u5728\u795e\u7ecf\u91cd\u75c7\u9886\u57df\u4e2d\uff0cEEG\u662f\u4e00\u9879\u91cd\u8981\u7684\u76d1\u6d4b\u6280\u672f\uff0c\u53ef\u7528\u4e8e\u766b\u75eb\u6301\u7eed\u72b6\u6001\u3001\u975e\u60ca\u53a5\u766b\u75eb\u6301\u7eed\u72b6\u6001\u7684\u76d1\u6d4b\u548c\u8bca\u65ad\uff0c\u4f46ICU\u80cc\u666f\u5bf9EEG\u5e72\u6270\u8f83\u5927\u4e14\u9547\u9759\u4e5f\u53ef\u80fd\u4f1a\u5e72\u6270EEG\u548c\u8fde\u7eed\u8111\u7535\u56fe\uff08continuous electroencephalography\uff0ccEEG\uff09<sup>[46]<\/sup>\u30022018\u5e74\uff0cDrohan\u7b49<sup>[47]<\/sup>\u7684\u4e00\u9879\u7814\u7a76\u63a2\u8ba8\u4e86\u5728\u5fc3\u640f\u9aa4\u505c\uff08cardiac arrest\uff0cCA\uff09\u7684\u660f\u8ff7\u5e78\u5b58\u8005\u4e2d\u5e94\u7528\u9547\u9759\u836f\u7269\u5bf9qEEG\u7684\u6f5c\u5728\u6df7\u6742\u5f71\u54cd\uff0c\u7ed3\u679c\u663e\u793a\u8f83\u9ad8\u7684\u632f\u5e45\u6574\u5408\u8111\u7535\u56fe\uff08amplitude-integrated electroencephalography\uff0caEEG\uff09\u548c\u8f83\u4f4e\u7684\u6291\u5236\u6bd4\uff08suppression ratio\uff0cSR\uff09\u53ef\u9884\u6d4bCA\u540e\u7684\u5b58\u6d3b\u7387\uff1b\u9547\u9759\u4f1a\u5f71\u54cdaEEG\u548cSR\uff0c\u4f46\u5e76\u672a\u5f71\u54cd\u8fd9\u4e9b\u53c2\u6570\u503c\u4e0e\u5b58\u6d3b\u7387\u4e4b\u95f4\u7684\u5173\u7cfb\u3002Ebtehaj\u7b49<sup>[48]<\/sup>\u7814\u7a76\u53d1\u73b0\uff0c\u5728\u8111\u5916\u4f24\u60a3\u8005\u4e2dGCS\u8bc4\u5206\u4e0eBIS\u5e73\u5747\u503c\u6709\u660e\u663e\u7684\u76f8\u5173\u6027\uff08r\uff1d0.88\uff0cP&lt;0.05\uff09\uff0c\u63d0\u793aBIS\u6216\u53ef\u4ee5\u4f5c\u4e3aGCS\u8bc4\u5206\u7684\u8865\u5145\uff0c\u7528\u4e8e\u9884\u6d4b\u8be5\u7fa4\u4f53\u7684\u9884\u540e\u3002\u53e6\u4e00\u9879\u89c2\u5bdf\u6027\u7814\u7a76\u663e\u793a\uff0cBIS\u53ef\u80fd\u662f\u8bc4\u4f30\u4e19\u6cca\u915a\u9547\u9759\u6548\u679c\u7684\u5ba2\u89c2\u5de5\u5177\uff0c\u5e76\u4e14\u5177\u6709\u8fde\u7eed\u6027<sup>[49]<\/sup>\u3002Yan\u7b49<sup>[50]<\/sup>\u7814\u7a76\u53d1\u73b0\uff0cBIS\u53ef\u7528\u4e8e\u6307\u5bfc\u7ef4\u6301\u66f4\u7a33\u5b9a\u7684\u9547\u9759\u72b6\u6001\u5e76\u4fdd\u6301ICP\u7684\u7a33\u5b9a\uff0c\u5c24\u5176\u662f\u9547\u9759\u6c34\u5e73\u8f83\u6df1\u65f6\u3002\u4e00\u9879RCT\u7814\u7a76\u8868\u660e\uff0c\u8054\u5408BIS\u76d1\u6d4b\u660e\u663e\u51cf\u5c11\u4e86\u7528\u4e8e\u8fbe\u5230\u76f8\u540c\u4e34\u5e8a\u9547\u9759\u6c34\u5e73\u7684\u9547\u9759\u5242\u603b\u5242\u91cf\uff0c\u4ece\u800c\u7f29\u77ed\u4e86\u82cf\u9192\u65f6\u95f4\uff0c\u4e14\u672a\u53d1\u73b0\u4efb\u4f55\u4e0d\u826f\u53cd\u5e94<sup>[51]<\/sup>\u3002\u8fd1\u5e74\u6765\u6709\u5173\u538b\u529b\u53cd\u5e94\u6307\u6570\uff08pressure reactivity index\uff0cPRx\uff09\u7684\u7814\u7a76\u9010\u6b65\u5f00\u5c55\uff0cFroese\u7b49<sup>[52]<\/sup>\u89c2\u5bdf\u4e865\u4f8bTBI\u60a3\u8005PRx\u4e0eBIS\u4e4b\u95f4\u7684\u5173\u7cfb\uff0c\u53d1\u73b0BIS\u4e0ePRx\u5448\u629b\u7269\u7ebf\u5173\u7cfb\uff0c\u8868\u660e\u53ef\u80fd\u5b58\u5728\u4e2a\u4f53\u7684\u6700\u4f73\u9547\u9759\u6df1\u5ea6\u3002<\/p>\n<\/p>\n<p>\u63a8\u8350\u610f\u89c19\uff1a\u795e\u7ecf\u91cd\u75c7\u60a3\u8005\u5e94\u8fdb\u884c\u9547\u9759\u8bc4\u4f30\u3002\uff08\u5171\u8bc6\u5ea6\uff1a100%\uff1b36\/36\uff09<\/p>\n<p>\u63a8\u8350\u610f\u89c110\uff1a\u5bf9\u4e8e\u795e\u7ecf\u91cd\u75c7\u60a3\u8005\uff0c\u53ef\u4f9b\u9009\u62e9\u7684\u4e3b\u89c2\u9547\u9759\u8bc4\u4f30\u5de5\u5177\u5305\u62ecSAS\u3001RASS\u7b49\uff0c\u4f46\u5bf9\u4e8e\u6301\u7eed\u660f\u8ff7\u7684\u60a3\u8005\u5e94\u7528\u4ef7\u503c\u6709\u9650\u3002\uff08\u5171\u8bc6\u5ea6\uff1a100%\uff1b36\/36\uff09<\/p>\n<p>\u63a8\u8350\u610f\u89c111\uff1a\u4f9d\u636e\u795e\u7ecf\u91cd\u75c7\u60a3\u8005\u7684\u7279\u70b9\uff0c\u53ef\u9009\u62e9\u4f7f\u7528qEEG\u3001BIS\u7b49\u5ba2\u89c2\u8bc4\u4f30\u5de5\u5177\u8bc4\u4f30\u9547\u9759\u6c34\u5e73\u3002\uff08\u5171\u8bc6\u5ea6\uff1a97.2%\uff1b35\/36\uff09<\/p>\n<p>\u4e34\u5e8a\u95ee\u98988\uff1a\u795e\u7ecf\u91cd\u75c7\u60a3\u8005\u9547\u9759\u6df1\u5ea6\u5982\u4f55\u9009\u62e9\uff1f<\/p>\n<p>\u80cc\u666f\uff1aICU\u4e2d\u5173\u4e8e\u9547\u9759\u6df1\u5ea6\u7684\u95ee\u9898\uff0c\u76ee\u524d\u5e7f\u6cdb\u7684\u63a8\u8350\u610f\u89c1\u662f\u9075\u5faaeCASH\uff08early Comfort using Analgesia\uff0cminimal Sedatives and maximal Humane care\uff0c\u65e9\u671f\u8212\u9002\u5316\uff0c\u4f7f\u7528\u9547\u75db\u3001\u6700\u5c0f\u5316\u9547\u9759\u548c\u6700\u5927\u5316\u4eba\u6587\u5173\u6000\uff09\u53caPADIS\u3014\u75bc\u75db\uff08pain\uff09\u3001\u8e81\u52a8\/\u9547\u9759\uff08agitation\/sedation\uff09\u3001\u8c35\u5984\uff08delirium\uff09\u3001\u5236\u52a8\uff08immobility\uff09\u3001\u7761\u7720\u7d0a\u4e71\uff08sleep disruption\uff09\u3015\u7b49\u7406\u5ff5\uff0c\u6700\u5c0f\u7a0b\u5ea6\u5730\u9547\u9759\u4ee5\u6700\u5927\u9650\u5ea6\u5730\u51cf\u5c11\u9547\u9759\u836f\u7269\u5242\u91cf\uff0c\u51cf\u5c11\u5bf9\u4fdd\u62a4\u6027\u7ea6\u675f\u7684\u9700\u6c42\u4ee5\u53ca\u7f29\u77ed\u673a\u68b0\u901a\u6c14\u65f6\u95f4\u7b49<sup>[53\uff0c54]<\/sup>\u3002\u800c\u5bf9\u4e8e\u5e94\u7528\u795e\u7ecf\u808c\u8089\u963b\u6ede\u836f\u7269\u3001\u766b\u75eb\u6301\u7eed\u72b6\u6001\u3001IH\u3001\u4eba\u673a\u5931\u8c03\u4ee5\u53ca\u4e25\u683c\u5236\u52a8\u7b49\u60c5\u51b5\u65f6\uff0c\u5e94\u8003\u8651\u91c7\u53d6\u6df1\u9547\u9759\u7b56\u7565\uff08RASS\u8bc4\u5206-3~-4\u5206\uff0cSAS\u8bc4\u52062\u5206\uff09\u3002\u795e\u7ecf\u91cd\u75c7\u60a3\u8005\u5408\u5e76\u4ee5\u4e0a\u60c5\u51b5\u65f6\u4e5f\u4e0d\u4f8b\u5916\uff0c\u6df1\u9547\u9759\u6709\u52a9\u4e8e\u795e\u7ecf\u529f\u80fd\u4fdd\u62a4\uff0c\u4f46\u4e5f\u53ef\u80fd\u59a8\u788d\u5bf9\u795e\u7ecf\u91cd\u75c7\u60a3\u8005\u795e\u7ecf\u7cfb\u7edf\u529f\u80fd\u7684\u5224\u65ad\uff0c\u5728\u5408\u9002\u7684\u65f6\u673a\u8fc7\u6e21\u5230\u6d45\u9547\u9759\/\u65e0\u9547\u9759\u6709\u52a9\u4e8e\u795e\u7ecf\u529f\u80fd\u7684\u8bc4\u4f30\u53ca\u673a\u68b0\u901a\u6c14\u7684\u64a4\u79bb\u7b49\uff0c\u56e0\u6b64\uff0c\u9547\u9759\u6df1\u5ea6\u7684\u9009\u62e9\u9700\u6839\u636e\u60a3\u8005\u7684\u60c5\u51b5\u6743\u8861\u5229\u5f0a\u52a8\u6001\u8bc4\u4f30\u3002<\/p>\n<p>\u8bc1\u636e\u603b\u7ed3\uff1a\u5173\u4e8e\u795e\u7ecf\u91cd\u75c7\u60a3\u8005\u9547\u9759\u6df1\u5ea6\u7684\u7814\u7a76\uff0c\u76ee\u524d\u5c1a\u7f3a\u4e4f\u76f8\u5173\u7cfb\u7edf\u8bc4\u4ef7\u3002Kandelman\u7b49<sup>[55]<\/sup>\u5728\u6700\u521d24 h\u5185\u5bf9\u6025\u6027\u8111\u635f\u4f24\uff08acute brain injury\uff0cABI\uff09\u60a3\u8005\u91c7\u53d6\u4e86\u6df1\u9547\u9759\u7b56\u7565\uff0c\u4e4b\u540e\u6bcf\u65e5\u8bc4\u4f30\u505c\u6b62\u9547\u9759\u7684\u53ef\u80fd\u6027\u3002\u56fd\u51852\u9879\u7814\u7a76\u5747\u91c7\u53d6\u4e86\u77ed\u671f\u6df1\u9547\u9759\u7b56\u7565<sup>[56\uff0c57]<\/sup>\u3002\u6768\u8d35\u8363\u7b49<sup>[58\uff0c59]<\/sup>\u8fdb\u884c\u76842\u9879RCT\u7814\u7a76\u5747\u5bf9ABI\u60a3\u8005\u91c7\u53d6\u4e86\u65e9\u671f\u76ee\u6807\u5bfc\u5411\u9547\u9759\uff08early goal directed sedation\uff0cEGDS\uff09\u7b56\u7565\uff0c\u8bc1\u660e\u4e86\u5176\u53ef\u884c\u6027\u53ca\u5bf9\u8111\u6c27\u4ee3\u8c22\u7b49\u7684\u5f71\u54cd\u3002\u503c\u5f97\u6ce8\u610f\u7684\u662f\uff0c\u8be5\u7814\u7a76\u4e2dABI\u60a3\u8005\u7684ICP\u59cb\u7ec8\u572820 mmHg\uff081 mmHg\u22480.133 kPa\uff09\u4ee5\u5185\uff0c\u56e0\u6b64\uff0c\u76f8\u6bd4\u4e8e\u8be5\u7fa4\u4f53\u800c\u8a00\uff0c\u5177\u6709IH\u6216\u6f5c\u5728IH\u98ce\u9669\u7684\u60a3\u8005\u662f\u5426\u9002\u5408EGDS\u5c1a\u4e0d\u786e\u5b9a\u3002<\/p>\n<\/p>\n<p>\u63a8\u8350\u610f\u89c112\uff1a\u5728\u5f3a\u70c8\u6000\u7591\u6709IH\u7b49\u5668\u5b98\u529f\u80fd\u4e0d\u7a33\u5b9a\u7684\u60c5\u51b5\u4e0b\uff0c\u5bf9\u795e\u7ecf\u91cd\u75c7\u60a3\u8005\u4e0d\u5e94\u8fdb\u884c\u6d45\u9547\u9759\uff08RASS\u8bc4\u5206-2~1\u5206\uff0cSAS\u8bc4\u52063~4\u5206\uff09\u3002\u5668\u5b98\u529f\u80fd\u8d8b\u4e8e\u7a33\u5b9a\u540e\uff0c\u53ef\u8003\u8651\u7531\u6df1\u9547\u9759\u5411\u6d45\u9547\u9759\/\u65e0\u9547\u9759\u8fc7\u6e21\u3002\uff08\u5171\u8bc6\u5ea6\uff1a97.2%\uff1b35\/36\uff09<\/p>\n<p>\u4e34\u5e8a\u95ee\u98989\uff1a\u795e\u7ecf\u91cd\u75c7\u60a3\u8005\u662f\u5426\u5e94\u8fdb\u884c\u795e\u7ecf\u5524\u9192\u8bd5\u9a8c\uff08neurological wake-up test\uff0cNWT\uff09\uff1f<\/p>\n<p>\u80cc\u666f\uff1a\u7531\u4e8e\u795e\u7ecf\u529f\u80fd\u76d1\u6d4b\u7684\u9700\u8981\uff0c\u5bf9\u795e\u7ecf\u91cd\u75c7\u60a3\u8005\u5b9e\u65bd\u9547\u75db\u9547\u9759\u548cNWT\u4e00\u76f4\u5b58\u5728\u4e89\u8bae\u3002\u5728ICU\u60a3\u8005\u4e2d\uff0c\u5e94\u7528\u9547\u75db\u9547\u9759\u6cbb\u7597\u5e38\u4f9d\u636e2018\u5e74PADIS\u6307\u5357\u91c7\u53d6\u9547\u75db\u4f18\u5148\u3001\u8f7b\u5ea6\u9547\u9759\u7684\u7b56\u7565<sup>[53]<\/sup>\uff0c\u7136\u800c\u76f8\u5173\u7814\u7a76\u5c06\u8111\u635f\u4f24\u60a3\u8005\u6392\u9664\u5728\u5916<sup>[60]<\/sup>\uff0c\u56e0\u6b64\u8be5\u7b56\u7565\u662f\u5426\u9002\u7528\u4e8e\u795e\u7ecf\u91cd\u75c7\u60a3\u8005\u6709\u5f85\u8ba8\u8bba\u3002NWT\u662f\u4e00\u79cd\u901a\u8fc7\u4e2d\u65ad\u9547\u9759\u6cbb\u7597\u4ee5\u8bc4\u4f30\u795e\u7ecf\u7cfb\u7edf\u529f\u80fd\u7684&#8217;\u91d1\u6807\u51c6&#8217;\uff0c\u662f\u5728\u6ca1\u6709\u9547\u9759\u836f\u7269\u5e72\u6270\u7684\u60c5\u51b5\u4e0b\u901a\u8fc7\u7b80\u5355\u6307\u4ee4\u751a\u81f3\u75bc\u75db\u523a\u6fc0\u7b49\u64cd\u4f5c\u83b7\u5f97\u6700\u4f73\u683c\u62c9\u65af\u54e5\u660f\u8ff7\u8bc4\u5206-\u8fd0\u52a8\u53cd\u5e94\uff08Glasgow coma scale-motor response\uff0cGCS-M\uff09\uff0c\u5e76\u5173\u6ce8\u77b3\u5b54\u53cd\u5e94\u4ee5\u53ca\u56db\u80a2\u5c40\u7076\u6027\u795e\u7ecf\u529f\u80fd\u7f3a\u635f<sup>[61]<\/sup>\u3002\u76ee\u524d\u5c1a\u65e0\u5173\u4e8e\u795e\u7ecf\u91cd\u75c7\u60a3\u8005\u5b9e\u65bd\u4e2d\u65ad\u9547\u9759\u83b7\u76ca\u4e0e\u5426\u7684\u76f4\u63a5\u8bc1\u636e\u3002NWT\u7684\u65f6\u673a\u4e5f\u5b58\u5728\u4e89\u8bae\uff0c\u4e3b\u8981\u662f\u8003\u8651\u5230IH\u7b49\u6f5c\u5728\u8111\u635f\u4f24\u98ce\u9669\uff0c\u8d38\u7136\u5b9e\u65bdNWT\u53ef\u80fd\u4f1a\u5bf9\u60a3\u8005\u9020\u6210\u4e8c\u6b21\u4f24\u5bb3\u3002\u7136\u800c\u5982\u4ec5\u901a\u8fc7ICP\u76d1\u6d4b\u6216\u5f71\u50cf\u5b66\u8bc4\u4f30\u7b49\u624b\u6bb5\u800c\u4e0d\u8003\u8651\u8fdb\u884cNWT\uff0c\u5c06\u4f1a\u7f3a\u5c11\u90e8\u5206\u795e\u7ecf\u7cfb\u7edf\u68c0\u67e5\uff08\u5982\u77b3\u5b54\u68c0\u6d4b\u6216\u80a2\u4f53\u8fd0\u52a8\u8bc4\u4f30\u7b49\uff09\uff0c\u53ef\u80fd\u4f1a\u6f0f\u8bca\u6216\u5ef6\u8fdf\u8bca\u65ad\u65b0\u53d1\u7684\u795e\u7ecf\u529f\u80fd\u969c\u788d\u3002\u5373\u4fbf\u5904\u4e8e\u9547\u9759\u72b6\u6001\uff0c\u795e\u7ecf\u7cfb\u7edf\u68c0\u67e5\u4e5f\u4e0d\u5e94\u5b8c\u5168\u88ab\u5f71\u50cf\u5b66\u68c0\u67e5\u3001\u591a\u6a21\u6001\u76d1\u6d4b\u7b49\u624b\u6bb5\u53d6\u4ee3\u3002\u4e00\u822c\u6765\u8bb2\uff0c\u5f53\u60a3\u8005ICP\u76f8\u5bf9\u7a33\u5b9a\u65f6\uff0c\u5b9e\u65bdNWT\u53ef\u80fd\u662f\u5b89\u5168\u7684\u3002\u4f46\u5f53\u60a3\u8005\u5904\u4e8e\u660e\u663e\u9ad8\u70ed\u3001\u766b\u75eb\u6301\u7eed\u72b6\u6001\u548c\uff08\u6216\uff09\u63a5\u53d7\u5df4\u6bd4\u59a5\u7c7b\u836f\u7269\u6cbb\u7597\u7b49\u60c5\u51b5\u4e0b\uff0c\u5e94\u907f\u514d\u4f7f\u7528NWT<sup>[62]<\/sup>\u3002SIBICC\u4e5f\u672a\u5c31\u4e2d\u65ad\u9547\u9759\u8fbe\u6210\u4e00\u81f4\uff0c\u800c\u662f\u91c7\u53d6\u70ed\u56fe\u7684\u5f62\u5f0f\uff0c\u5728\u77b3\u5b54\u72b6\u6001\u3001GCS-M\u8bc4\u5206\u3001\u6539\u826fCT\u5206\u7c7b\u3001\u53ef\u63a5\u53d7\u7684ICP\u65f6\u957f\uff0c\u4ee5\u53ca\u4e4b\u524d\u4efb\u4f55IH\u6240\u9700\u7684\u6cbb\u7597\u7a0b\u5ea6\uff08\u65e0\u30011\u7ea7\u30012\u7ea7\u62163\u7ea7\uff09\u7b49\u4e0d\u540c\u6761\u4ef6\u4e0b\u8fdb\u884c\u7efc\u5408\u8bc4\u4f30\uff0c\u6700\u5927\u9650\u5ea6\u5730\u63d0\u9ad8\u4e2d\u65ad\u9547\u9759\u7684\u5b89\u5168\u6027<sup>[13]<\/sup>\u3002\u5176\u4ed6\u9700\u8981\u8fdb\u884c\u98ce\u9669\u5206\u5c42\u7684\u60c5\u51b5\u5305\u62ec\u8840\u6d41\u52a8\u529b\u5b66\u4e0d\u7a33\u5b9a\u3001\u8fd1\u671f\u5fc3\u808c\u7f3a\u8840\u3001\u9885\u5185\u987a\u5e94\u6027\u964d\u4f4e\u7b49\u3002\u56e0\u6b64\uff0c\u9700\u8981\u5728\u8bc4\u4f30\u795e\u7ecf\u529f\u80fd\u5e26\u6765\u7684\u83b7\u76ca\u4e0e\u98ce\u9669\u7684\u57fa\u7840\u4e0a\u7efc\u5408\u8003\u8651NWT\u3002<\/p>\n<\/p>\n<p>\u8bc1\u636e\u603b\u7ed3\uff1a2013\u5e74Skoglund\u7b49<sup>[63]<\/sup>\u6536\u96c6\u4e8616\u4e2aNCU\u4e2d\u9547\u75db\u9547\u9759\u7684\u4f7f\u7528\u60c5\u51b5\uff0c\u53d1\u73b0\u670950%\u7684\u4e2d\u5fc3\u4ece\u672a\u8fdb\u884c\u8fc7NWT\u3002\u800c\u8fd1\u5e74\u6765\u795e\u7ecf\u91cd\u75c7\u60a3\u8005\u7684NWT\u9010\u6e10\u88ab\u91cd\u89c6\uff0c\u4f46\u662f\u51fa\u4e8e\u5bf9NWT\u8fc7\u7a0b\u4e2d\u6f5c\u5728\u98ce\u9669\u7684\u62c5\u5fe7\uff0c\u4ecd\u7136\u7f3a\u4e4f\u7edf\u4e00\u7684\u7ba1\u7406\u7b56\u7565\u3002Kandelman\u7b49<sup>[55]<\/sup>\u8003\u8651\u5230\u9547\u9759\u6cbb\u7597\u662fABI\u60a3\u8005\u521d\u59cb\u6cbb\u7597\u65b9\u6848\u7684\u5fc5\u8981\u7ec4\u6210\u90e8\u5206\uff0c\u56e0\u6b64\u5728\u6700\u521d\u768424 h\u5185\u672a\u8fdb\u884c\u5e38\u89c4\u9547\u9759\u4e2d\u65ad\u6216\u51cf\u5c11\u8bd5\u9a8c\uff0c\u4f46\u6bcf4 h\u4f7f\u7528RASS\u8bc4\u4f301\u6b21\u9547\u9759\u6df1\u5ea6\uff1b\u7136\u540e\u5728\u6700\u521d24 h\u540e\u6bcf\u65e5\u8bc4\u4f30\u505c\u6b62\u9547\u9759\u7684\u53ef\u80fd\u6027\u30022023\u5e74Schmidbauer\u7b49<sup>[64]<\/sup>\u8fdb\u884c\u6a2a\u65ad\u9762\u8c03\u67e5\u53d1\u73b0\uff0c\u5728\u975e\u521b\u4f24\u6027SAH\u60a3\u8005\u4e2d\uff0c62.2%\uff0823\/37\uff09\u7684\u795e\u7ecf\u91cd\u75c7\u60a3\u8005\u8fdb\u884c\u4e86\u5b9a\u671fNWT\u3002Esnault\u7b49<sup>[65]<\/sup>\u7684\u7814\u7a76\u53d1\u73b0\uff0c\u5728\u7eb3\u5165\u7684242\u4f8b\u8fdb\u884c\u6c14\u7ba1\u63d2\u7ba1\u7684TBI\u60a3\u8005\u4e2d\uff0c\u670940%\u5b9e\u65bd\u4e86\u65e9\u671f\u795e\u7ecf\u5524\u9192\u8bd5\u9a8c\uff08early neurological wake-up test\uff0cENWT\uff09\uff0c\u6210\u529f\u7387\u4e3a60.5%\uff0c\u5931\u8d25\u539f\u56e0\u4e3b\u8981\u4e3a27\u4f8b\uff0871%\uff09\u60a3\u8005\u51fa\u73b0\u795e\u7ecf\u529f\u80fd\u6076\u5316\uff0c10\u4f8b\uff0826%\uff09\u60a3\u8005\u51fa\u73b0\u547c\u5438\u7a98\u8feb\u8868\u73b0\u3002\u5982\u679c\u786c\u819c\u4e0b\u8840\u80bf\u7684\u539a\u5ea6&gt;5 mm\u6216\u521d\u59cbGCS&lt;5\u5206\uff0c\u53ef\u80fd\u4f1a\u51fa\u73b0ENWT\u5931\u8d25\u3002<\/p>\n<p>Skoglund\u7b49<sup>[66]<\/sup>\u7684\u65e9\u671f\u7814\u7a76\u663e\u793a\uff0c\u5728\u5bf9TBI\u6216SAH\u60a3\u8005\u8fdb\u884cNWT\u65f6ICP\u5747\u6709\u5347\u9ad8\uff0c\u591a\u6570CPP\u6c34\u5e73\u4e5f\u9002\u5ea6\u589e\u52a0\u3002\u8be5\u7814\u7a76\u56e2\u961f\u968f\u540e\u53d1\u73b0sTBI\u60a3\u8005\u5728\u8fdb\u884cNWT\u65f6\u80be\u4e0a\u817a\u76ae\u8d28\u6fc0\u7d20\u548c\u76ae\u8d28\u9187\u6c34\u5e73\u5347\u9ad8<sup>[67]<\/sup>\u3002\u56e0\u6b64\uff0cNWT\u5f15\u8d77\u7684\u5e94\u6fc0\u53cd\u5e94\u5bf9\u8111\u4ee3\u8c22\u6216\u8111\u6c27\u5408\u7b49\u7684\u5f71\u54cd\u4e5f\u4e0d\u5bb9\u5ffd\u89c6\u30022012\u5e74\uff0cHelbok\u7b49<sup>[68]<\/sup>\u5bf920\u4f8b\u91cd\u75c7ABI\u60a3\u8005\u8fdb\u884c\u4e86\u591a\u6a21\u6001\u795e\u7ecf\u76d1\u6d4b\uff0c\u5206\u6790\u4e86\u4e2d\u65ad\u9547\u9759\u8bd5\u9a8c\u671f\u95f4\u7684\u8111\u4e73\u9178\u3001\u4e19\u916e\u9178\u3001\u8461\u8404\u7cd6\u6c34\u5e73\u53caICP\u3001CPP\u3001\u8111\u7ec4\u7ec7\u6c27\u5206\u538b\uff08partial pressure of brain oxygen\uff0cPbtO<sub>2<\/sub>\uff09\uff0c\u57281\u6b21\uff082%\uff09\u4e2d\u65ad\u9547\u9759\u6d4b\u8bd5\u4e2d\u53d1\u73b0\u4e86\u65b0\u7684\u795e\u7ecf\u529f\u80fd\u7f3a\u635f\uff0c1\/3\u7684\u4e2d\u65ad\u9547\u9759\u6d4b\u8bd5\u7531\u4e8e\u9ad8ICP\uff08&gt;20 mmHg\uff09\u3001\u8e81\u52a8\u6216\u5168\u8eab\u8840\u6c27\u9971\u548c\u5ea6\u964d\u4f4e\u88ab\u8feb\u4e2d\u6b62\u3002\u5728\u4e0d\u5f97\u4e0d\u4e2d\u6b62\u7684\u4e2d\u65ad\u9547\u9759\u6d4b\u8bd5\u4e2d\uff0c\u89c2\u5bdf\u5230ICP\u663e\u8457\u589e\u52a0\u548cPbtO<sub>2<\/sub>\u663e\u8457\u4e0b\u964d\uff08\u5747P&lt;0.05\uff09\uff0c\u5305\u62ec67%\u7684PbtO<sub>2<\/sub>\u4e34\u754c\u503c&lt;20 mmHg\uff0c\u6709\u8111\u4ee3\u8c22\u969c\u788d\u7684\u8d8b\u52bf\uff08P&lt;0.07\uff09\u3002\u57fa\u4e8e\u8be5\u7814\u7a76\uff0c\u6709\u5b66\u8005\u5efa\u8bae\u5728NCU\u4e2d\u5e94\u907f\u514d\u4f7f\u7528NWT\u30022014\u5e74\uff0cSkoglund\u7b49<sup>[69]<\/sup>\u7814\u7a76\u53d1\u73b0\uff0cNWT\u6ca1\u6709\u660e\u663e\u6539\u53d8PbtiO<sub>2<\/sub>\uff0c\u9888\u9759\u8109\u7403\u8840\u6c27\u9971\u548c\u5ea6\uff08jugular bulb venous oxygen saturation\uff0cSjvO<sub>2<\/sub>\uff09\u4e5f\u65e0\u75c5\u7406\u6027\u6539\u53d8\uff0c\u8bf4\u660eNWT\u53ef\u4ee5\u5728\u5927\u591a\u6570sTBI\u60a3\u8005\u4e2d\u5b89\u5168\u8fdb\u884c\u3002<\/p>\n<p>\u63a8\u8350\u610f\u89c113\uff1a\u795e\u7ecf\u91cd\u75c7\u60a3\u8005\u6709\u5fc5\u8981\u8003\u8651NWT\u4ee5\u8bc4\u4f30\u795e\u7ecf\u7cfb\u7edf\u529f\u80fd\uff0c\u4f46\u5e94\u5728\u5e73\u8861\u83b7\u76ca\u4e0e\u98ce\u9669\u7684\u57fa\u7840\u4e0a\u51b3\u5b9aNWT\u7684\u65f6\u673a\u3002\uff08\u5171\u8bc6\u5ea6\uff1a100%\uff1b36\/36\uff09<\/p>\n<p>\u63a8\u8350\u610f\u89c114\uff1a\u5728\u5f3a\u70c8\u6000\u7591\u6709IH\u7b49\u4e25\u91cd\u60c5\u51b5\u4e0b\u4e0d\u5e94\u5bf9\u795e\u7ecf\u91cd\u75c7\u60a3\u8005\u5e38\u89c4\u8fdb\u884cNWT\u3002\uff08\u5171\u8bc6\u5ea6\uff1a100%\uff1b36\/36\uff09<\/p>\n<p>\u4e34\u5e8a\u95ee\u989810\uff1a\u795e\u7ecf\u91cd\u75c7\u60a3\u8005\u9547\u75db\u9547\u9759\u6cbb\u7597\u65f6\u662f\u5426\u5e94\u8fdb\u884c\u795e\u7ecf\u7cfb\u7edf\u68c0\u67e5\uff1f<\/p>\n<p>\u80cc\u666f\uff1a\u795e\u7ecf\u91cd\u75c7\u60a3\u8005\u65e9\u671f\u5e38\u51fa\u73b0\u75bc\u75db\u3001\u8e81\u52a8\u7b49\u4e34\u5e8a\u8868\u73b0\uff0c\u8fd9\u4e5f\u662f\u9547\u75db\u9547\u9759\u6cbb\u7597\u7684\u9002\u5e94\u8bc1\u3002\u7136\u800c\uff0c\u82e5\u56e0\u9547\u75db\u9547\u9759\u6cbb\u7597\u800c\u5ffd\u89c6\u795e\u7ecf\u7cfb\u7edf\u68c0\u67e5\uff0c\u53ef\u80fd\u4f1a\u6f0f\u8bca\u65b0\u53d1\u7684\u795e\u7ecf\u7cfb\u7edf\u75c5\u53d8\u3002<\/p>\n<p>\u8bc1\u636e\u603b\u7ed3\uff1a2014\u5e74\u795e\u7ecf\u5371\u91cd\u75c7\u76d1\u62a4\u4e2d\u591a\u6a21\u6001\u76d1\u6d4b\u56fd\u9645\u591a\u5b66\u79d1\u5171\u8bc6\u5bf9\u4e34\u5e8a\u8bc4\u4f30\u7ed9\u4e88\u4e867\u6761\u63a8\u8350\u610f\u89c1\uff0c\u5176\u4e2d\u5305\u62ec\u63a8\u8350\u5bf9\u4e8e\u6240\u6709\u7684\u6210\u4ebaABI\u60a3\u8005\u5e38\u89c4\u4f7f\u7528\u683c\u62c9\u65af\u54e5\u660f\u8ff7\u8bc4\u5206-\u77b3\u5b54\u53cd\u5e94\uff08Glasgow coma seale-pupils\uff0cGCS-P\uff09\u6216\u5168\u9762\u65e0\u53cd\u5e94\u6027\u91cf\u8868\uff08full outline of unresponsiveness\uff0cFOUR\uff09\u8bc4\u4f30<sup>[70]<\/sup>\u3002<\/p>\n<p>2014\u5e74\u6b27\u6d32\u5371\u91cd\u75c5\u533b\u5b66\u4f1a\u6307\u5357\u5efa\u8baeICU\u60a3\u8005\u5747\u5e94\u8fdb\u884c\u5e38\u89c4\u795e\u7ecf\u7cfb\u7edf\u68c0\u67e5\uff0c\u4e0d\u4ec5\u5982\u6b64\uff0c\u660f\u8ff7\u60a3\u8005\u5e94\u5305\u62ec\u5bf9\u523a\u6fc0\u7684\u53cd\u5e94\u3001\u8111\u5e72\u8bc4\u4f30\u3001\u8fd0\u52a8\u53cd\u5e94\u548c\u547c\u5438\u6a21\u5f0f\u7b49\u989d\u5916\u8bc4\u4f30\uff0c\u5e76\u4e14\u5728\u7279\u6b8a\u6761\u4ef6\u4e0b\u5f71\u50cf\u5b66\u68c0\u67e5\u4e5f\u6709\u52a9\u4e8e\u53d1\u73b0\u4e0d\u660e\u539f\u56e0\u7684\u610f\u8bc6\u969c\u788d<sup>[71]<\/sup>\u3002\u5373\u4fbf\u60a3\u8005\u63a5\u53d7\u9547\u75db\u9547\u9759\u6cbb\u7597\u4e5f\u4e0d\u4f8b\u5916\u3002Yan\u7b49<sup>[72]<\/sup>\u7684\u7814\u7a76\u4e2d\u670948.19%\u7684\u8111\u5352\u4e2d\u60a3\u8005\u63a5\u53d7\u9547\u9759\u6cbb\u7597\uff0cGCS\u3001RASS\u3001SAS\u4ee5\u53ca\u808c\u8089\u6d3b\u52a8\u8bc4\u5206\u6cd5\uff08motor activity assessment scale\uff0cMAAS\uff09\u53ef\u4ee5\u4f5c\u4e3aNCU\u7684\u610f\u8bc6\u7b5b\u67e5\u5de5\u5177\u3002Kandelman\u7b49<sup>[55]<\/sup>\u5728ABI\u60a3\u8005\u9547\u9759\u671f\u95f4\u91c7\u53d6GCS-M\u3001\u683c\u62c9\u65af\u54e5\u660f\u8ff7\u8bc4\u5206-\u7741\u773c\u53cd\u5e94\u8bc4\u4f30\uff08Glasgow coma scale-eye opening\uff0cGCS-E\uff09\u3001FOUR\u3001\u8111\u5e72\u53cd\u5c04\u8bc4\u4f30\u3001RASS\u7b49\u8fdb\u884c\u795e\u7ecf\u7cfb\u7edf\u68c0\u67e5\u3002Hosseini\u7b49<sup>[73]<\/sup>\u7684\u7814\u7a76\u663e\u793aGCS\u3001FOUR\u5177\u6709\u826f\u597d\u5730\u9884\u6d4bTBI\u60a3\u8005\u75c5\u6b7b\u7387\u7684\u80fd\u529b\u3002<\/p>\n<\/p>\n<p>\u63a8\u8350\u610f\u89c115\uff1a\u795e\u7ecf\u91cd\u75c7\u60a3\u8005\u9547\u75db\u9547\u9759\u6cbb\u7597\u65f6\u4ecd\u5e94\u8fdb\u884c\u795e\u7ecf\u7cfb\u7edf\u68c0\u67e5\u3002\u795e\u7ecf\u7cfb\u7edf\u68c0\u67e5\u5e94\u5305\u62ec\u610f\u8bc6\u8bc4\u4f30\u3001\u77b3\u5b54\u53cd\u5e94\u3001\u795e\u7ecf\u7cfb\u7edf\u4f53\u683c\u68c0\u67e5\uff08\u5982\u9885\u795e\u7ecf\u3001\u8fd0\u52a8\u3001\u611f\u89c9\u3001\u547c\u5438\u6a21\u5f0f\u3001\u8111\u5e72\u53cd\u5c04\u7b49\uff09\u3001\u5b9e\u9a8c\u5ba4\u68c0\u67e5\u4ee5\u53ca\u5f71\u50cf\u5b66\u68c0\u67e5\u7b49\u3002\uff08\u5171\u8bc6\u5ea6\uff1a100%\uff1b36\/36\uff09<\/p>\n<p>\u4e34\u5e8a\u95ee\u989811\uff1a\u795e\u7ecf\u91cd\u75c7\u60a3\u8005\u9547\u75db\u9547\u9759\u6cbb\u7597\u8fc7\u7a0b\u4e2d\u662f\u5426\u5e94\u4f7f\u75281\u79cd\u6216\u591a\u79cd\u8111\u529f\u80fd\u591a\u6a21\u6001\u76d1\u6d4b\u6280\u672f\u6765\u8fdb\u884c\u5ba2\u89c2\u76d1\u6d4b\uff1f<\/p>\n<p>\u80cc\u666f\uff1a\u4e34\u5e8a\u533b\u751f\u5e38\u91c7\u53d6\u4e3b\u89c2\u8bc4\u4f30\u7684\u65b9\u5f0f\u5224\u65adICU\u60a3\u8005\u9547\u75db\u9547\u9759\u6cbb\u7597\u7684\u6709\u6548\u6027\u3002\u7136\u800c\u5728\u9547\u75db\u9547\u9759\u6cbb\u7597\u65f6\u9884\u8ba1NWT\u98ce\u9669\u8f83\u9ad8\u7684\u60a3\u8005\u7fa4\u4f53\u4e2d\uff0c\u91c7\u53d6\u591a\u6a21\u6001\u76d1\u6d4b\u6280\u672f\u6216\u53ef\u4ece\u4e0d\u540c\u89d2\u5ea6\u8fdb\u884c\u8111\u529f\u80fd\u8bc4\u4f30\u3002ICP\u76d1\u6d4b\u53ef\u4ee5\u5224\u65ad\u662f\u5426\u5b58\u5728IH\uff1b\u7ecf\u9885\u591a\u666e\u52d2\u68c0\u6d4b\uff08transcranial Doppler\uff0cTCD\uff09\u6709\u52a9\u4e8e\u8111\u8840\u6d41\u7684\u52a8\u6001\u8bc4\u4f30\uff1b\u8fd1\u7ea2\u5916\u5149\u8c31\u8111\u8840\u6c27\u9971\u548c\u5ea6\u76d1\u6d4b\u53ef\u53cd\u6620\u8840\u6d41\u91cf\u4e0e\u8111\u6c27\u5e73\u8861\u7684\u53d8\u5316\uff1bPRx\u53ef\u8f85\u52a9\u5224\u65ad\u76ee\u524d\u7684\u9547\u9759\u6cbb\u7597\u662f\u5426\u5904\u4e8e\u6700\u4f18\u3002\u8054\u5408\u4ee5\u4e0a\u5355\u4e00\u6216\u591a\u79cd\u65b9\u5f0f\u7684\u76d1\u6d4b\u6280\u672f\u6709\u52a9\u4e8e\u9547\u75db\u9547\u9759\u6cbb\u7597\u7684\u7cbe\u7ec6\u5316\u7ba1\u7406\uff0c\u8fbe\u5230\u8111\u4fdd\u62a4\u7684\u76ee\u7684\u3002<\/p>\n<p>\u8bc1\u636e\u603b\u7ed3\uff1aPoignant\u7b49<sup>[74]<\/sup>\u8fdb\u884c\u7684\u4e00\u9879\u5355\u65e5\u6a2a\u65ad\u9762\u8c03\u67e5\u663e\u793a\uff0c\u8d85\u8fc760%\u7684\u9547\u9759\u60a3\u8005\u8fdb\u884c\u4e86\u8111\u529f\u80fd\u76d1\u6d4b\uff0cIH\u60a3\u8005\u63a5\u53d7\u8111\u529f\u80fd\u76d1\u6d4b\u7684\u6bd4\u4f8b\u4e3a74%\u3002Amantini\u7b49<sup>[75]<\/sup>\u8fdb\u884c\u7684\u4e00\u9879\u524d\u77bb\u6027\u89c2\u5bdf\u7814\u7a76\u7eb3\u5165\u4e8668\u4f8bNCU\u60a3\u8005\uff0c\u5176\u4e2d\u7ea660%\u4e3a\u6df1\u9547\u9759\u72b6\u6001\uff0c\u5bf9\u5176\u8fdb\u884c\u8fde\u7eedEEG-\u4f53\u611f\u8bf1\u53d1\u7535\u4f4d\uff08somatosensory evoked potentials\uff0cSEP\uff09\u76d1\u6d4b\uff0c\u80fd\u591f\u6700\u5927\u7a0b\u5ea6\u5730\u8bc6\u522b\u8111\u529f\u80fd\u7684\u6076\u5316\u3002SEP\u7684\u52a8\u6001\u53d8\u5316\u53ef\u80fd\u65e9\u4e8eICP\u7684\u5347\u9ad8\uff0c\u63d0\u524d\u53d1\u73b0\u795e\u7ecf\u529f\u80fd\u6076\u5316\u3002sTBI\u60a3\u8005\u8111\u7ec4\u7ec7\u6c27\u76d1\u6d4b\u548c\u7ba1\u7406\u7b2c\u4e8c\u9636\u6bb5\u8bd5\u9a8c\uff08brain oxygen optimization in severe traumatic brain injury phase-\u2161\uff0cBOOST-\u2161\uff09\u662f\u4e00\u9879\u591a\u4e2d\u5fc3RCT\u7814\u7a76\uff0c\u7eb3\u5165\u4e86119\u4f8bsTBI\u60a3\u8005\uff0c\u7ed3\u679c\u663e\u793a\uff0c\u901a\u8fc7\u7ed3\u5408ICP\u548c\u8111\u7ec4\u7ec7\u6c27\u7684\u591a\u6a21\u6001\u76d1\u6d4bsTBI\u60a3\u8005\u7684\u7ba1\u7406\u51cf\u5c11\u4e86\u8111\u7ec4\u7ec7\u7f3a\u6c27\uff0c\u4e0e\u5355\u7eaf\u57fa\u4e8eICP\u76d1\u6d4b\u7684\u6cbb\u7597\u76f8\u6bd4\uff0c\u6709\u964d\u4f4e\u75c5\u6b7b\u7387\u548c\u5b9e\u73b0\u66f4\u6709\u5229\u7ed3\u5c40\u7684\u8d8b\u52bf<sup>[76]<\/sup>\u3002Froese\u7b49<sup>[52]<\/sup>\u7684\u7814\u7a76\u63d0\u793a\uff0c\u82e5\u80fd\u901a\u8fc7PRx\u7b49\u6307\u6807\u53d1\u73b0&#8217;\u6700\u4f73&#8217;\u9547\u9759\u6df1\u5ea6\uff0c\u53ef\u4ee5\u6700\u5927\u7a0b\u5ea6\u5730\u5236\u8ba2\u4e2a\u4f53\u5316\u9547\u9759\u65b9\u6848\uff0c\u4ece\u800c\u907f\u514d\u9547\u9759\u4e0d\u8db3\u6216\u9547\u9759\u8fc7\u5ea6\u7ed9\u8111\u7ec4\u7ec7\u5e26\u6765\u7684\u6f5c\u5728\u5371\u5bb3\u3002<\/p>\n<p>\u63a8\u8350\u610f\u89c116\uff1a\u591a\u6a21\u6001\u76d1\u6d4b\u6280\u672f\u53ef\u4ece\u4e0d\u540c\u89d2\u5ea6\u52a8\u6001\u8bc4\u4f30\u9547\u75db\u9547\u9759\u6cbb\u7597\u7684\u5b89\u5168\u6027\u53ca\u6709\u6548\u6027\u3002\uff08\u5171\u8bc6\u5ea6\uff1a100%\uff1b36\/36\uff09<\/p>\n<p>\u4e34\u5e8a\u95ee\u989812\uff1a\u795e\u7ecf\u91cd\u75c7\u60a3\u8005\u662f\u5426\u5e94\u8fdb\u884c\u8c35\u5984\u8bc4\u4f30\uff1f<\/p>\n<p>\u4e34\u5e8a\u95ee\u989813\uff1a\u795e\u7ecf\u91cd\u75c7\u60a3\u8005\u7684\u8c35\u5984\u8bc4\u4f30\u5de5\u5177\u5e94\u5982\u4f55\u9009\u62e9\uff1f<\/p>\n<p>\u80cc\u666f\uff1a\u6839\u636e\u7f8e\u56fd\u7cbe\u795e\u75c5\u5b66\u534f\u4f1a\u7684\u7b2c5\u7248\u300a\u7cbe\u795e\u75be\u75c5\u8bca\u65ad\u4e0e\u7edf\u8ba1\u624b\u518c\u300b\uff08DSM-\u2164\uff09\uff0c\u8c35\u5984\u662f\u4e00\u7ec4\u4ee5\u8111\u529f\u80fd\u969c\u788d\u6025\u6027\u53d1\u4f5c\u4e3a\u7279\u5f81\u7684\u4e34\u5e8a\u7efc\u5408\u5f81\uff0c\u5176\u7279\u70b9\u5305\u62ec\u6025\u6027\u8d77\u75c5\u53ca\u77ed\u6682\u800c\u6ce2\u52a8\u7684\u75c5\u7a0b<sup>[77]<\/sup>\u3002\u8c35\u5984\u53ef\u5bfc\u81f4\u673a\u68b0\u901a\u6c14\u65f6\u95f4\u53ca\u4f4f\u9662\u65f6\u95f4\u5ef6\u957f\uff0c\u589e\u52a0\u4f4f\u9662\u8d39\u7528\uff0c\u5e76\u4e0e\u8fdc\u671f\u8ba4\u77e5\u529f\u80fd\u969c\u788d\u76f8\u5173\u3002\u7531\u4e8e\u795e\u7ecf\u91cd\u75c7\u60a3\u8005\u5b58\u5728\/\u6f5c\u5728\u795e\u7ecf\u529f\u80fd\u969c\u788d\uff0c\u65e2\u5f80\u6709\u5173\u8c35\u5984\u7684\u7814\u7a76\u5e38\u5c06\u795e\u7ecf\u91cd\u75c7\u60a3\u8005\u7fa4\u4f53\u6392\u9664\u5728\u5916\u3002\u795e\u7ecf\u91cd\u75c7\u60a3\u8005\u5b58\u5728\u57fa\u7840\u7684\u795e\u7ecf\u7cfb\u7edf\u5668\u8d28\u6027\u75c5\u53d8\uff0c\u8c35\u5984\u7684\u53d1\u751f\u98ce\u9669\u53ef\u80fd\u66f4\u9ad8\uff0c\u800c\u8bc4\u4f30\u4e0d\u8db3\u53ef\u80fd\u5bfc\u81f4\u8fd9\u90e8\u5206\u60a3\u8005\u7684\u8c35\u5984\u53d1\u751f\u7387\u88ab\u4f4e\u4f30\u3002\u8fd1\u5e74\u6765\u5df2\u6709\u8bf8\u591a\u805a\u7126\u5728\u795e\u7ecf\u91cd\u75c7\u60a3\u8005\u8c35\u5984\u65b9\u9762\u7684\u7814\u7a76\uff0c\u5305\u62ec\u8111\u5352\u4e2d\u3001TBI\u3001\u8111\u8840\u7ba1\u75be\u75c5\u4ee5\u53ca\u8111\u80bf\u7624\u5207\u9664\u672f\u540e\u60a3\u8005\u7b49\u7fa4\u4f53\u3002\u76ee\u524d\uff0c\u91cd\u75c7\u60a3\u8005\u8c35\u5984\u8bc4\u4f30\u5e38\u7528\u7684\u5de5\u5177\u5305\u62ecICU\u610f\u8bc6\u6a21\u7cca\u8bc4\u4f30\u6cd5\uff08confusion assessment model for intensive care unit\uff0cCAM-ICU\uff09\u548c\u91cd\u75c7\u76d1\u62a4\u8c35\u5984\u7b5b\u67e5\u91cf\u8868\uff08intensive care delirium screening checklist\uff0cICDSC\uff09\u7b49\uff0c\u4f46\u5176\u662f\u5426\u9002\u7528\u4e8e\u795e\u7ecf\u91cd\u75c7\u60a3\u8005\u4ecd\u9700\u9a8c\u8bc1\u3002\u53e6\u5916\uff0c\u7531\u4e8e\u795e\u7ecf\u91cd\u75c7\u60a3\u8005\u5e38\u4f34\u6709\u795e\u7ecf\u529f\u80fd\u7f3a\u635f\uff08\u660f\u8ff7\u3001\u75f4\u5446\u3001\u5931\u8bed\u3001\u504f\u762b\u7b49\uff09\uff0c\u540c\u65f6\u9547\u75db\u9547\u9759\u836f\u7269\u7684\u4f7f\u7528\u53ef\u80fd\u4f1a\u5f71\u54cd\u5bf9\u60a3\u8005\u795e\u7ecf\u529f\u80fd\u7684\u5224\u65ad\uff0c\u56e0\u6b64\uff0c\u4e00\u65b9\u9762\uff0c\u5728\u8be5\u7fa4\u4f53\u4e2d\u8c35\u5984\u5f80\u5f80\u4e0d\u6613\u88ab\u8bc6\u522b\uff1b\u53e6\u4e00\u65b9\u9762\uff0c\u90e8\u5206\u60a3\u8005\u96be\u4ee5\u8fdb\u884c\u8c35\u5984\u8bc4\u4f30\u3002<\/p>\n<\/p>\n<p>\u8bc1\u636e\u603b\u7ed3\uff1a2022\u5e74Lawson\u7b49<sup>[78]<\/sup>\u7684\u4e00\u9879\u8303\u56f4\u7efc\u8ff0\u7eb3\u516518\u9879\u7814\u7a76\uff0c\u7ed3\u679c\u663e\u793a\uff0c\u8111\u5352\u4e2d\u60a3\u8005\u8c35\u5984\u7684\u53d1\u751f\u7387\u4e3a12%~75%\u3002\u8c35\u5984\u7684\u9884\u6d4b\u56e0\u7d20\u5305\u62ec\u8001\u9f84\u3001\u65e2\u5f80\u75f4\u5446\u75c7\u75c5\u53f2\u3001\u75be\u75c5\u4e25\u91cd\u7a0b\u5ea6\u8f83\u9ad8\u548c\u4f7f\u7528\u7269\u7406\u7ea6\u675f\u63aa\u65bd\u30022018\u5e74Patel\u7b49<sup>[79]<\/sup>\u7684\u4e00\u9879\u7cfb\u7edf\u8bc4\u4ef7\u5171\u7eb3\u51657\u9879\u7814\u7a76\uff0c\u603b\u8ba11 173\u4f8b\u795e\u7ecf\u91cd\u75c7\u60a3\u8005\uff0c\u7814\u7a76\u663e\u793a\uff0c\u5bf9\u8bca\u65ad\u4e3a\u539f\u53d1\u6027\u795e\u7ecf\u7cfb\u7edf\u75be\u75c5\u7684\u60a3\u8005\u53ef\u8fdb\u884c\u8c35\u5984\u8bc4\u4f30\uff0c\u8c35\u5984\u53d1\u751f\u7387\u4e3a12%~43%\uff0c\u4e0eICU\u4f4f\u9662\u65f6\u95f4\u548c\u603b\u4f4f\u9662\u65f6\u95f4\u5ef6\u957f\u4ee5\u53ca\u795e\u7ecf\u529f\u80fd\u4e0d\u826f\u9884\u540e\u589e\u52a0\u6709\u5173\u30022019\u5e74Mansutti\u7b49<sup>[80]<\/sup>\u7684\u4e00\u9879\u7cfb\u7edf\u8bc4\u4ef7\u663e\u793a\uff0c\u5728\u6025\u6027\u8111\u5352\u4e2d\u60a3\u8005\u7684\u8c35\u5984\u7b5b\u67e5\u5de5\u5177\u4e2d\uff0c4\u9879\u8c35\u5984\u5feb\u901f\u8bca\u65ad\u65b9\u6848\uff08the 4-item assessment test\uff0c4AT\uff09\u548cCAM-ICU\u5e94\u7528\u5e7f\u6cdb\uff0c4AT\u7684\u654f\u611f\u5ea6\u4e3a90.2%~100%\uff0c\u7279\u5f02\u5ea6\u4e3a64.5%~86.0%\uff1bCAM-ICU\u7684\u654f\u611f\u5ea6\u4e3a76%\uff0c\u7279\u5f02\u5ea6\u4e3a98%\u3002<\/p>\n<p>\u591a\u9879\u89c2\u5bdf\u6027\u7814\u7a76\u4e5f\u5bf9\u8c35\u5984\u7684\u7b5b\u67e5\u5de5\u5177\u8fdb\u884c\u4e86\u8bc4\u4ef7\uff0c\u5e76\u62a5\u544a\u4e86\u8111\u5352\u4e2d\u3001TBI\u7b49\u795e\u7ecf\u91cd\u75c7\u60a3\u8005\u8c35\u5984\u7684\u53d1\u751f\u7387<sup>[81\uff0c82\uff0c83\uff0c84\uff0c85\uff0c86\uff0c87\uff0c88]<\/sup>\u3002\u6709\u7814\u7a76\u663e\u793a\uff0cCAM-ICU\u548cICDSC\u662f\u8bca\u65ad\u8c35\u5984\u7684\u6709\u6548\u5de5\u5177\uff0c\u7136\u800cFrenette\u7b49<sup>[82]<\/sup>\u53d1\u73b0\uff0cCAM-ICU\u548cICDSC\u5728\u4e2d\u5ea6\u521b\u4f24\u6027\u75be\u75c5\u548c\u6df1\u5ea6\u9547\u9759\u60a3\u8005\u4e2d\u7684\u7279\u5f02\u5ea6\u8f83\u4f4e\uff1bWeiss\u7b49<sup>[83]<\/sup>\u4ea6\u53d1\u73b0\uff0c\u9547\u9759\u4f1a\u660e\u663e\u5f71\u54cdCAM-ICU\u548cICDSC\u5bf9\u8c35\u5984\u7684\u7b5b\u67e5\u3002\u503c\u5f97\u6ce8\u610f\u7684\u662f\uff0c\u6709\u7814\u7a76\u663e\u793a\u8c35\u5984\u9633\u6027\u7684\u60a3\u8005\u5b58\u5728\u8f83\u9ad8\u6bd4\u4f8b\u7684\u795e\u7ecf\u7cfb\u7edf\u7f3a\u9677\uff0c\u5982\u610f\u8bc6\u969c\u788d\u3001\u8868\u8fbe\u6027\u5931\u8bed\u3001\u8bed\u8a00\u7406\u89e3\u80fd\u529b\u53d7\u635f\u548c\u504f\u4fa7\u5ffd\u7565\u75c7\uff0c\u8fd9\u53ef\u80fd\u4f1a\u6df7\u6dc6\u5176\u8bc4\u4f30\uff0c\u5bfc\u81f4\u6f0f\u8bca<sup>[84]<\/sup>\u3002Reznik\u7b49<sup>[85]<\/sup>\u7814\u7a76\u53d1\u73b0\uff0c\u8d85\u8fc71\/3\u53ef\u7591\u8c35\u5984\u7684\u8111\u5352\u4e2d\u60a3\u8005\u53ef\u80fd\u88abCAM-ICU\u9057\u6f0f\uff1b\u800c\u5bf9\u4e8e\u8111\u5352\u4e2d\u540e\u5931\u8bed\u75c7\u60a3\u8005\uff0cICDSC\u5305\u542b\u975e\u8bed\u8a00\u7279\u5f81\uff0c\u8fd9\u53ef\u80fd\u4f7f\u5176\u6bd4CAM-ICU\u5bf9\u795e\u7ecf\u529f\u80fd\u969c\u788d\u60a3\u8005\u66f4\u6709\u4ef7\u503c<sup>[86]<\/sup>\u3002Bo\u03b2elmann\u7b49<sup>[87]<\/sup>\u5bf9\u8111\u5352\u4e2d\u540e\u5931\u8bed\u60a3\u8005\u8fdb\u884c\u8c35\u5984\u7b5b\u67e5\uff0c\u53d1\u73b0ICDSC\u7684\u622a\u65ad\u503c\u63d0\u9ad8\u5230\u22655\u5206\u65f6\uff0c\u654f\u611f\u5ea6\u4e3a90.0%\u301495%\u53ef\u4fe1\u533a\u95f4\uff0895% confidence interval\uff0c95%CI\uff09\u4e3a81.9%~95.8%\u3015\uff0c\u7279\u5f02\u5ea6\u4e3a75.0%\uff0895%CI\u4e3a67.2%~81.8%\uff09\u3002\u8c35\u5984\u7684\u5371\u9669\u56e0\u7d20\u5f88\u591a\uff0c\u591a\u6570\u89c2\u5bdf\u6027\u7814\u7a76\u4e5f\u62a5\u9053\u4e86\u53ef\u80fd\u7684\u5371\u9669\u56e0\u7d20\u4ee5\u53ca\u4e0d\u826f\u9884\u540e\uff0c\u6d89\u53ca\u75c5\u79cd\u8986\u76d6\u8111\u5352\u4e2d\u3001TBI\u3001\u6025\u6027\u9885\u5185\u51fa\u8840\u3001SAH\u7b49\u3002\u4e3b\u8981\u5371\u9669\u56e0\u7d20\u5305\u62ec\u5e74\u9f84\u3001\u7269\u7406\u7ea6\u675f\u3001\u8113\u6bd2\u75c7\u3001\u673a\u68b0\u901a\u6c14\u3001\u5931\u8bed\u75c7\u3001\u8111\u767d\u8d28\u75c5\u53d8\u7b49<sup>[88\uff0c89\uff0c90\uff0c91\uff0c92\uff0c93\uff0c94\uff0c95\uff0c96\uff0c97]<\/sup>\uff1b\u56fd\u5185\u4ea6\u6709\u7814\u7a76\u62a5\u9053\uff0c\u4e3b\u8981\u805a\u7126\u7fa4\u4f53\u4e3a\u6025\u6027\u8111\u8840\u7ba1\u75c5\u3001\u9885\u8111\u80bf\u7624\u5f00\u9885\u672f\u540e\u60a3\u8005\uff0c\u5e74\u9f84\u3001\u672f\u4e2d\u56e0\u7d20\u4ee5\u53ca\u672f\u540e\u53d1\u70ed\u3001\u75bc\u75db\u3001\u7269\u7406\u7ea6\u675f\u3001\u7761\u7720\u5265\u593a\u3001\u53cc\u4fa7\u989d\u90e8\u79ef\u6c14\u7b49\u4e0e\u8c35\u5984\u53d1\u751f\u53ef\u80fd\u76f8\u5173<sup>[98\uff0c99\uff0c100\uff0c101]<\/sup>\u3002<\/p>\n<p>\u63a8\u8350\u610f\u89c117\uff1a\u795e\u7ecf\u91cd\u75c7\u60a3\u8005\u5e94\u8fdb\u884c\u8c35\u5984\u8bc4\u4f30\u3002\u4e0d\u5e94\u56e0\u5df2\u6709\/\u6f5c\u5728\u7684\u795e\u7ecf\u529f\u80fd\u7f3a\u635f\u800c\u5ffd\u7565\u8c35\u5984\u8bc4\u4f30\u3002\uff08\u5171\u8bc6\u5ea6\uff1a100%\uff1b36\/36\uff09<\/p>\n<p>\u63a8\u8350\u610f\u89c118\uff1a\u5bf9\u4e8e\u795e\u7ecf\u91cd\u75c7\u60a3\u8005\uff0c\u5e38\u7528\u7684\u8c35\u5984\u8bc4\u4f30\u5de5\u5177\u6709CAM-ICU\u6216ICDSC\u30024AT\u7b49\u5feb\u901f\u7b5b\u67e5\u5de5\u5177\u6709\u52a9\u4e8e\u65e9\u671f\u8bc6\u522b\u8c35\u5984\u3002\uff08\u5171\u8bc6\u5ea6\uff1a97.2%\uff1b35\/36\uff09<\/p>\n<p>\u63a8\u8350\u610f\u89c119\uff1a\u5bf9\u4e8e\u5b58\u5728\u610f\u8bc6\u969c\u788d\u3001\u5931\u8bed\u75c7\u7b49\u795e\u7ecf\u529f\u80fd\u7f3a\u635f\u7684\u795e\u7ecf\u91cd\u75c7\u60a3\u8005\uff0c\u5e94\u6839\u636e\u5177\u4f53\u60c5\u51b5\u9009\u62e9\u5408\u9002\u7684\u8bc4\u4f30\u5de5\u5177\uff0c\u540c\u65f6\u8c28\u614e\u89e3\u8bfb\u8c35\u5984\u7684\u8bc4\u4f30\u7ed3\u679c\u3002\u5bf9\u4e8e\u5931\u8bed\u75c7\u60a3\u8005\uff0cICDSC\u6bd4CAM-ICU\u66f4\u6709\u4ef7\u503c\u3002\uff08\u5171\u8bc6\u5ea6\uff1a97.2%\uff1b35\/36\uff09<\/p>\n<p>\u63a8\u8350\u610f\u89c120\uff1a\u795e\u7ecf\u91cd\u75c7\u60a3\u8005\u8c35\u5984\u53d1\u751f\u7684\u5371\u9669\u56e0\u7d20\u6709\u5e74\u9f84\u3001\u673a\u68b0\u901a\u6c14\u3001\u8113\u6bd2\u75c7\u3001\u5931\u8bed\u75c7\u3001\u7761\u7720\u5265\u593a\u3001\u7269\u7406\u7ea6\u675f\u3001\u989d\u90e8\u75c5\u53d8\u7b49\u3002\uff08\u5171\u8bc6\u5ea6\uff1a100%\uff1b36\/36\uff09<\/p>\n<\/p>\n<p>5\u3000\u9547\u75db\u9547\u9759\u836f\u7269\u9009\u62e9<\/p>\n<p>\u4e34\u5e8a\u95ee\u989814\uff1a\u795e\u7ecf\u91cd\u75c7\u60a3\u8005\u7684\u9547\u75db\u9547\u9759\u836f\u7269\u5982\u4f55\u9009\u62e9\uff1f<\/p>\n<p>\u80cc\u666f\uff1a\u8fc4\u4eca\u5c1a\u65e0\u8bc1\u636e\u8868\u660e\u67d0\u79cd\u9547\u75db\u9547\u9759\u836f\u7269\u5177\u6709\u7edd\u5bf9\u7684\u9009\u62e9\u4f18\u52bf\u3002\u5728\u8fdb\u884c\u836f\u7269\u9009\u62e9\u65f6\uff0c\u4e34\u5e8a\u533b\u751f\u5e38\u8003\u8651\u836f\u7269\u7684\u53ef\u53ca\u6027\u3001\u6709\u6548\u6027\u548c\u5b89\u5168\u6027\uff0c\u65e2\u8981\u8fbe\u5230\u8bbe\u5b9a\u7684\u9547\u75db\u9547\u9759\u76ee\u6807\uff0c\u4e5f\u8981\u907f\u514d\u5176\u4e0d\u826f\u53cd\u5e94\uff0c\u5982\u547c\u5438\u6291\u5236\u3001\u5faa\u73af\u6291\u5236\u548c\u5bf9\u5176\u4ed6\u5668\u5b98\uff08\u5982\u809d\u810f\u548c\u80be\u810f\u7b49\uff09\u4ea7\u751f\u7684\u4e0d\u826f\u4f5c\u7528\u3002\u795e\u7ecf\u91cd\u75c7\u60a3\u8005\u5c24\u4e3a\u7279\u6b8a\u7684\u4e00\u70b9\u5728\u4e8e\u8111\u529f\u80fd\u969c\u788d\u4e0e\u9547\u75db\u9547\u9759\u836f\u7269\u5bf9\u795e\u7ecf\u529f\u80fd\u7684\u5f71\u54cd\u5e76\u5b58\uff0c\u5bfc\u81f4\u4e34\u5e8a\u60c5\u51b5\u66f4\u4e3a\u590d\u6742\u3002\u795e\u7ecf\u91cd\u75c7\u60a3\u8005\u5728\u9009\u62e9\u9547\u75db\u9547\u9759\u836f\u7269\u65f6\u5e94\u9075\u5faa2\u4e2a\u57fa\u672c\u539f\u5219\uff0c\u5373\u5bf9\u4e2d\u67a2\u795e\u7ecf\u7cfb\u7edf\u65e0\u9644\u52a0\u635f\u5bb3\u4e14\u836f\u7269\u4f5c\u7528\u80fd\u591f\u5feb\u901f\u6d88\u9664<sup>[102]<\/sup>\u3002\u76ee\u524d\u5e38\u7528\u7684\u9547\u75db\u7c7b\u836f\u7269\u5305\u62ec\u963f\u7247\u7c7b\u836f\u7269\u548c\u975e\u963f\u7247\u7c7b\u836f\u7269\uff1b\u9547\u9759\u7c7b\u836f\u7269\u5305\u62ec\u82ef\u4e8c\u6c2e\u7c7b\u3001\u4e19\u6cca\u915a\u3001\u53f3\u7f8e\u6258\u54aa\u5b9a\u7b49\u3002\u88682\u5217\u51fa\u4e86\u5e38\u7528\u9547\u75db\u9547\u9759\u836f\u7269\u5bf9\u9885\u5185\u5916\u8840\u6d41\u52a8\u529b\u5b66\u7684\u5f71\u54cd\uff1b\u88683\u5217\u51fa\u4e86\u5e38\u7528\u9547\u75db\u9547\u9759\u836f\u7269\u7684\u4e3b\u8981\u836f\u7406\u5b66\u7279\u70b9\uff1b\u88684\uff0c\u88685\u5217\u51fa\u4e86\u5e38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antiinflammatory 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ICU\uff0cPAD\uff09\u6307\u5357\u57fa\u4e8e\u957f\u6548\u82ef\u4e8c\u6c2e\u7c7b\u836f\u7269\u52b3\u62c9\u897f\u6cee\u7684\u7814\u7a76\u7ed3\u679c\u63d0\u793a\uff0c\u82ef\u4e8c\u6c2e\u7c7b\u836f\u7269\u53ef\u80fd\u662f\u8c35\u5984\u53d1\u751f\u7684\u9ad8\u5371\u56e0\u7d20<sup>[105]<\/sup>\uff1b\u7136\u800c\u8fd1\u5e74\u6765\u591a\u9879\u7814\u7a76\u663e\u793a\uff0c\u5e94\u7528\u975e\u82ef\u4e8c\u6c2e\u7c7b\u836f\u7269\u7684\u60a3\u8005\u8c35\u5984\u53d1\u751f\u7387\u548c\u77ed\u671f\u75c5\u6b7b\u7387\u5e76\u4e0d\u4f18\u4e8e\u5e94\u7528\u82ef\u4e8c\u6c2e\u7c7b\u836f\u7269\u7684\u60a3\u8005<sup>[54\uff0c106\uff0c107\uff0c108\uff0c109]<\/sup>\u3002\u76ee\u524d\u5728\u795e\u7ecf\u91cd\u75c7\u9886\u57df\u4e2d\u5c1a\u65e0\u82ef\u4e8c\u6c2e\u7c7b\u836f\u7269\u4e0e\u8c35\u5984\u9884\u9632\u548c\u53d1\u751f\u7684\u76f8\u5173\u7814\u7a76\u3002<\/p>\n<p>\u4e19\u6cca\u915a\u5c5e\u4e8e\u5242\u91cf\u4f9d\u8d56\u6027\u9547\u9759\u836f\u7269\uff0c\u5e7f\u6cdb\u7528\u4e8e\u63a7\u5236IH\u4ee5\u53ca\u766b\u75eb\u6301\u7eed\u72b6\u6001\u3002\u7136\u800c\uff0c\u4e19\u6cca\u915a\u5bf9\u8840\u6d41\u52a8\u529b\u5b66\u7684\u5f71\u54cd\u8f83\u5927\uff0c\u4e14\u5f53\u4e19\u6cca\u915a\u5242\u91cf\u8fc7\u5927\u4e14\u5e94\u7528\u65f6\u95f4\u8fc7\u957f\u65f6\u53ef\u80fd\u589e\u52a0\u4e19\u6cca\u915a\u8f93\u6ce8\u7efc\u5408\u5f81\uff08propofol infusion syndrome\uff0cPRIS\uff09\u7684\u53d1\u751f\u98ce\u9669\uff0c\u4e00\u65e6\u6000\u7591\u60a3\u8005\u53d1\u751fPRIS\uff0c\u5e94\u7acb\u5373\u505c\u836f\u30022017\u5e74\u7f8e\u56fd\u7b2c4\u7248sTBI\u7ba1\u7406\u6307\u5357\u660e\u786e\uff0c\u5f53\u957f\u65f6\u95f4\uff08&gt;48 h\uff09\u4f7f\u7528\u4e19\u6cca\u915a\u65f6\u5e94\u8c28\u614e\uff0c\u5242\u91cf\u4e0d\u5b9c&gt;4 mg\u00b7kg<sup>-1<\/sup>\u00b7h<sup>-1<\/sup><sup>[14]<\/sup>\u3002\u53f3\u7f8e\u6258\u54aa\u5b9a\u662f\u4e00\u79cd\u9ad8\u9009\u62e9\u6027\u4e2d\u67a2\u03b1<sub>2<\/sub>\u53d7\u4f53\u6fc0\u52a8\u5242<sup>[110\uff0c111]<\/sup>\uff0c\u5177\u6709\u9547\u9759\u4f5c\u7528\u540c\u65f6\u517c\u987e\u9547\u75db\uff0c\u5176\u4f18\u52bf\u5728\u4e8e\u53ef\u51cf\u5c11\u963f\u7247\u7c7b\u836f\u7269\u53ca\u5176\u4ed6\u9547\u9759\u836f\u7269\u7684\u5242\u91cf\uff0c\u53ef\u5728\u4e00\u5b9a\u7a0b\u5ea6\u4e0a\u63a7\u5236IH\uff0c\u5176\u4e3b\u8981\u4e0d\u826f\u53cd\u5e94\u662f\u5fc3\u52a8\u8fc7\u7f13\u3002<\/p>\n<p>\u8fd1\u5e74\u6765\uff0c\u4e00\u4e9b\u65b0\u578b\u9547\u9759\u836f\u7269\u9646\u7eed\u4e0a\u5e02\uff0c\u5982\u73af\u6cca\u915a\u3001\u745e\u9a6c\u5511\u4ed1\u7b49\u3002\u73af\u6cca\u915a\u5728\u4e19\u6cca\u915a\u5206\u5b50\u7ed3\u6784\u57fa\u7840\u4e0a\u5f15\u5165\u73af\u4e19\u57fa\uff0c\u4fdd\u7559\u4e19\u6cca\u915a\u5feb\u901f\u8d77\u6548\u3001\u5feb\u901f\u6e05\u9664\u7b49\u7279\u70b9\u3002\u745e\u9a6c\u5511\u4ed1\u662f\u4e00\u79cd\u65b0\u578b\u77ed\u6548\u82ef\u4e8c\u6c2e\u7c7b\u836f\u7269\uff0c\u7531\u8840\u6db2\u4e2d\u975e\u7279\u5f02\u6027\u916f\u9176\u4ee3\u8c22\u3002\u5bf9\u4e8e\u795e\u7ecf\u91cd\u75c7\u60a3\u8005\uff0c\u8fd9\u4e9b\u836f\u7269\u7684\u76f8\u5173\u7814\u7a76\u6709\u9650\u3002<\/p>\n<\/p>\n<p>\u9547\u75db\u836f\u7269\u7684\u8bc1\u636e\u603b\u7ed3\uff1a\u5173\u4e8e\u795e\u7ecf\u91cd\u75c7\u60a3\u8005\u9547\u75db\u836f\u7269\u7684\u9009\u62e9\uff0c\u56fd\u5185\u5916\u4f7f\u7528\u60c5\u51b5\u5b58\u5728\u5dee\u5f02\u3002\u6211\u56fd\u4e00\u9879\u6a2a\u65ad\u9762\u8c03\u67e5\u7814\u7a76\u663e\u793a\uff0c\u4ee5\u963f\u7247\u7c7b\u836f\u7269\u4e3a\u4e3b\uff0c\u5176\u4e2d\u82ac\u592a\u5c3c\u548c\u8212\u82ac\u592a\u5c3c\u662f\u6700\u5e38\u7528\u7684\u963f\u7247\u7c7b\u836f\u7269<sup>[112]<\/sup>\u3002\u800c\u6765\u81ea\u6cd5\u56fd\u3001\u52a0\u62ff\u5927\u3001\u7f8e\u56fd\u3001\u6fb3\u5927\u5229\u4e9a\u548c\u65b0\u897f\u51705\u4e2a\u56fd\u5bb6\u7684\u6a2a\u65ad\u9762\u7814\u7a76\u663e\u793a\uff0c\u963f\u7247\u7c7b\u836f\u7269\u548c\u5bf9\u4e59\u9170\u6c28\u57fa\u915a\/\u6251\u70ed\u606f\u75db\u662f\u6700\u5e38\u7528\u7684\u9547\u75db\u836f\u7269\u3002\u9547\u75db\u836f\u7269\u7684\u9009\u62e9\u56e0\u60a3\u8005\u795e\u7ecf\u75c5\u7406\u5b66\u7279\u5f81\u800c\u5f02\uff0c\u5176\u4e2d\uff0c\u5728TBI\u3001SAH\u7b49\u75be\u75c5\u4e2d\uff0c\u963f\u7247\u7c7b\u836f\u7269\u662f\u4e00\u7ebf\u9547\u75db\u836f\u7269\uff1b\u5728\u8111\u80bf\u7624\u3001\u766b\u75eb\u3001\u8131\u9ad3\u9798\u75c5\u53d8\u3001\u4e09\u53c9\u795e\u7ecf\u75db\u7b49\u75be\u75c5\u4e2d\uff0c\u5bf9\u4e59\u9170\u6c28\u57fa\u915a\u662f\u4e00\u7ebf\u836f\u7269<sup>[113]<\/sup>\u3002<\/p>\n<p>2019\u5e74\u4e00\u9879\u57fa\u4e8e22\u9879\u7814\u7a76\u7684\u7cfb\u7edf\u8bc4\u4ef7\u5206\u6790\u4e86\u963f\u7247\u7c7b\u836f\u7269\u5bf9\u795e\u7ecf\u91cd\u75c7\u60a3\u8005\u8111\u751f\u7406\u529f\u80fd\u7684\u5f71\u54cd\uff0c\u7ed3\u679c\u63d0\u793a\uff0c\u5355\u6b21\u5feb\u901f\u9759\u8109\u6ce8\u5c04\u6216\u77ed\u65f6\u95f4\u5185\u7ed9\u4e88\u8f83\u5927\u5242\u91cf\u963f\u7247\u7c7b\u836f\u7269\u4f1a\u5bfc\u81f4ICP\u5347\u9ad8\uff0c\u800c\u7f13\u6162\u6ef4\u5b9a\u5f0f\u7ed9\u4e88\u963f\u7247\u7c7b\u836f\u7269\u53ef\u907f\u514d\u6b64\u7c7b\u60c5\u51b5\u7684\u53d1\u751f\uff1b\u5bf9\u4e0d\u540c\u963f\u7247\u7c7b\u836f\u7269\u8fdb\u884c\u6bd4\u8f83\uff0c\u5982\u82ac\u592a\u5c3c\u4e0e\u8212\u82ac\u592a\u5c3c\u3001\u82ac\u592a\u5c3c\u4e0e\u5417\u5561\u3001\u8212\u82ac\u592a\u5c3c\u4e0e\u963f\u82ac\u592a\u5c3c\u7b49\uff0c\u672a\u53d1\u73b0\u663e\u8457\u5dee\u5f02<sup>[15]<\/sup>\u3002\u963f\u7247\u7c7b\u836f\u7269\u7684\u4e0d\u540c\u8f93\u6ce8\u65b9\u5f0f\u5bf9\u9885\u5185\u5916\u8840\u6d41\u52a8\u529b\u5b66\u7684\u5f71\u54cd\u4e5f\u9700\u52a0\u4ee5\u5173\u6ce8\uff0c\u5c3d\u53ef\u80fd\u9009\u62e9\u5bf9\u9885\u5185\u5916\u8840\u6d41\u52a8\u529b\u5b66\u7279\u522b\u662fICP\u3001CPP\u4e0d\u826f\u5f71\u54cd\u66f4\u5c0f\u7684\u8f93\u6ce8\u65b9\u5f0f\u3002<\/p>\n<p>\u795e\u7ecf\u91cd\u75c7\u60a3\u8005\u4e2d\u6bd4\u8f83\u4e0d\u540c\u963f\u7247\u7c7b\u836f\u7269\u5bf9\u9884\u540e\u5f71\u54cd\u7684\u7814\u7a76\u8f83\u5c11\u30022022\u5e74\u4e00\u9879\u56de\u987e\u6027\u7814\u7a76\u663e\u793a\uff0c\u8212\u82ac\u592a\u5c3c\u8f83\u82ac\u592a\u5c3c\u5728\u673a\u68b0\u901a\u6c14\u65f6\u95f4\u3001\u8fbe\u5230\u76ee\u6807\u9547\u75db\u9547\u9759\u6240\u9700\u65f6\u95f4\u53caICU\u4f4f\u9662\u65f6\u95f4\u7b49\u65b9\u9762\u66f4\u6709\u4f18\u52bf<sup>[114]<\/sup>\u3002\u65e9\u671f\u4e00\u9879\u7814\u7a76\u8bc4\u4f30\u4e86\u745e\u82ac\u592a\u5c3c\u5728\u795e\u7ecf\u91cd\u75c7\u60a3\u8005\u4e2d\u7684\u5e94\u7528\u4ef7\u503c\uff0c\u8868\u73b0\u4e3a\u4ee5\u745e\u82ac\u592a\u5c3c\u4e3a\u57fa\u7840\u7684\u9547\u75db\u9547\u9759\u7b56\u7565\u4f7f\u60a3\u8005\u7684\u82cf\u9192\u66f4\u8fc5\u901f\uff0c\u505c\u836f\u540e\u80fd\u591f\u5728\u53ef\u9884\u6d4b\u7684\u65f6\u95f4\u5185\u8fdb\u884c\u795e\u7ecf\u529f\u80fd\u8bc4\u4f30<sup>[115]<\/sup>\u3002<\/p>\n<p>\u5173\u4e8e\u6c2f\u80fa\u916e\u5728\u795e\u7ecf\u91cd\u75c7\u60a3\u8005\u4e2d\u7684\u4f7f\u7528\u6b64\u524d\u4e00\u76f4\u5b58\u5728\u4e89\u8bae\uff0c\u4e3b\u8981\u662f\u7531\u4e8e\u5176\u5bf9ICP\u7684\u4e0d\u5229\u5f71\u54cd<sup>[116\uff0c117]<\/sup>\uff0c\u4f46\u8be5\u7ed3\u679c\u5728\u8fd1\u5e74\u6765\u53d1\u8868\u7684\u7814\u7a76\u4e2d\u672a\u5f97\u5230\u9a8c\u8bc1<sup>[118\uff0c119\uff0c120]<\/sup>\u30022020\u5e74Gregers\u7b49<sup>[121]<\/sup>\u7684\u4e00\u9879\u7cfb\u7edf\u8bc4\u4ef7\u4e2d6\u9879\u7814\u7a76\u8bc4\u4f30\u4e86\u6c2f\u80fa\u916e\u5bf9\u6210\u4eba\u60a3\u8005ICP\u7684\u5f71\u54cd\uff0c\u5176\u4e2d\u67093\u9879\u7814\u7a76\u663e\u793a\uff0c\u6c2f\u80fa\u916e\u4e0e\u5bf9\u7167\u7ec4ICP\u65e0\u660e\u663e\u5dee\u5f02\uff1b1\u9879\u7814\u7a76\u663e\u793a\uff0c\u5c3d\u7ba1\u5e94\u7528\u4e86\u6c2f\u80fa\u916e\uff0c\u4f46ICP\u5347\u9ad8\u662f\u53d1\u751f\u5728\u5438\u75f0\u8fc7\u7a0b\u4e2d\uff1b1\u9879\u7814\u7a76\u663e\u793a\uff0c\u5c3d\u7ba1ICP\u5347\u9ad8\uff0c\u4f46\u6ca1\u6709\u8bc1\u636e\u8868\u660e\u4f1a\u9020\u6210\u5371\u5bb3\u3002\u603b\u4f53\u800c\u8a00\uff0c\u6ca1\u6709\u53d1\u73b0\u8111\u635f\u4f24\u60a3\u8005\u4f7f\u7528\u6c2f\u80fa\u916e\u540e\u51fa\u73b0\u4e0eICP\u589e\u52a0\u6216\u75c5\u6b7b\u7387\u589e\u52a0\u76f8\u5173\u7684\u6301\u7eed\u4e0d\u826f\u53cd\u5e94\u3002\u540c\u65f6\uff0c\u591a\u9879\u5c0f\u6837\u672c\u7814\u7a76\u63d0\u793a\uff0c\u4e0e\u5176\u4ed6\u9547\u9759\u836f\u7269\u76f8\u6bd4\uff0c\u6c2f\u80fa\u916e\u80fd\u591f\u6709\u6548\u51cf\u5c11\u64ad\u6563\u6027\u53bb\u6781\u5316\u7684\u53d1\u751f\uff0c\u4e14\u5448\u5242\u91cf\u4f9d\u8d56\u5173\u7cfb<sup>[122\uff0c123\uff0c124\uff0c125]<\/sup>\u3002<\/p>\n<\/p>\n<p>\u9547\u9759\u836f\u7269\u7684\u8bc1\u636e\u603b\u7ed3\uff1a2013\u5e74Skoglund\u7b49<sup>[63]<\/sup>\u8fdb\u884c\u7684\u4e00\u9879\u591a\u4e2d\u5fc3\u6a2a\u65ad\u9762\u8c03\u67e5\u7814\u7a76\u663e\u793a\uff0c\u7ea650%\u7684NCU\u4ee5\u4e19\u6cca\u915a\u4f5c\u4e3a\u9996\u9009\u9547\u9759\u836f\u7269\uff0c\u5176\u4f59\u7684NCU\u5219\u4ee5\u54aa\u8fbe\u5511\u4ed1\u4f5c\u4e3a\u9996\u9009\u9547\u9759\u836f\u7269\u30022022\u5e74\u6cd5\u56fd\u7684\u4e00\u9879\u6a2a\u65ad\u9762\u8c03\u67e5\u7814\u7a76\u663e\u793a\uff0c\u5e38\u7528\u7684\u9547\u9759\u836f\u7269\u662f\u54aa\u8fbe\u5511\u4ed1\uff0858.1%\uff09\u548c\u4e19\u6cca\u915a\uff0840.5%\uff09<sup>[74]<\/sup>\u30022022\u5e74Cinotti\u7b49<sup>[126]<\/sup>\u5173\u4e8e\u795e\u7ecf\u91cd\u75c7\u60a3\u8005\u62d4\u7ba1\u7684\u56fd\u9645\u591a\u4e2d\u5fc3\u524d\u77bb\u6027\u89c2\u5bdf\u7814\u7a76\u4e2d\uff0c\u5171\u7eb3\u51651 512\u4f8b\u5c1d\u8bd5\u62d4\u7ba1\u6216\u6c14\u7ba1\u5207\u5f00\u7684\u795e\u7ecf\u91cd\u75c7\u60a3\u8005\uff0c\u8be5\u961f\u5217\u4eba\u7fa4\u9547\u9759\u836f\u7269\u4f7f\u7528\u6392\u540d\u524d2\u4f4d\u5206\u522b\u662f\u4e19\u6cca\u915a\u548c\u54aa\u8fbe\u5511\u4ed1\u3002\u6211\u56fd\u76f8\u5173\u7814\u7a76\u663e\u793a\uff0c\u54aa\u8fbe\u5511\u4ed1\u548c\u4e19\u6cca\u915a\u6700\u5e38\u7528\u4e8e\u8111\u635f\u4f24\u60a3\u8005<sup>[112]<\/sup>\u3002\u603b\u4f53\u6765\u8bf4\uff0c\u54aa\u8fbe\u5511\u4ed1\u548c\u4e19\u6cca\u915a\u662f\u6700\u5e38\u7528\u7684\u4e24\u79cd\u9547\u9759\u836f\u7269\u3002<\/p>\n<p>2019\u5e74\u4e00\u9879\u524d\u77bb\u6027\u7814\u7a76\u663e\u793a\uff0c\u54aa\u8fbe\u5511\u4ed1\u53ef\u6709\u6548\u63a7\u5236\u65e0\u9700\u795e\u7ecf\u808c\u8089\u963b\u6ede\u836f\u7269\u7684sTBI\u60a3\u8005\u7684ICP\uff08ICP\u226420 mmHg\uff09<sup>[127]<\/sup>\u3002\u4e5f\u6709\u5927\u91cf\u7814\u7a76\u6bd4\u8f83\u4e86\u54aa\u8fbe\u5511\u4ed1\u4e0e\u4e19\u6cca\u915a\u5728\u5371\u91cd\u75c7\u60a3\u8005\u9547\u9759\u6cbb\u7597\u4e2d\u7684\u4f5c\u7528\uff0c\u76ee\u524d\u5c1a\u65e0\u786e\u5b9a\u6027\u8bc1\u636e\u8868\u660e\u5b70\u4f18\u5b70\u52a3<sup>[53]<\/sup>\u3002\u5173\u4e8e\u54aa\u8fbe\u5511\u4ed1\u4e0e\u4e19\u6cca\u915a\u5728\u795e\u7ecf\u91cd\u75c7\u60a3\u8005\u4e2d\u7684\u6bd4\u8f83\u7814\u7a76\u4e5f\u672a\u5f97\u51fa\u9633\u6027\u7ed3\u679c<sup>[16]<\/sup>\u3002\u8fd1\u5e74\u6765\u5bf9\u4e8e\u53f3\u7f8e\u6258\u54aa\u5b9a\u5728\u795e\u7ecf\u91cd\u75c7\u4e2d\u6709\u6548\u6027\u548c\u5b89\u5168\u6027\u7684\u7814\u7a76\u9010\u6e10\u6df1\u5165\uff0c2019\u5e74\u4e00\u9879\u56de\u987e\u6027\u961f\u5217\u7814\u7a76\u663e\u793a\uff0c\u53f3\u7f8e\u6258\u54aa\u5b9a\u53ef\u51cf\u5c11\u53d1\u751fIH\u4e8b\u4ef6\u7684sTBI\u60a3\u8005\u5bf9\u62a2\u6551\u6027\u9ad8\u6e17\u900f\u6cbb\u7597\u7684\u9700\u6c42<sup>[128]<\/sup>\u30022017\u5e742\u9879\u7814\u7a76\u8bc4\u4f30\u4e86\u53f3\u7f8e\u6258\u54aa\u5b9a\u9632\u6cbbPSH\u7684\u6548\u679c\uff0c\u53d1\u73b0\u53f3\u7f8e\u6258\u54aa\u5b9a\u53ef\u51cf\u8f7bPSH\u60a3\u8005\u7684\u75c7\u72b6\uff0c\u4f46\u4e0d\u80fd\u9632\u6b62PSH\u590d\u53d1<sup>[129]<\/sup>\u3002\u53f3\u7f8e\u6258\u54aa\u5b9a\u5bf9\u4e8esTBI\u672f\u540e\u60a3\u8005\u7684PSH\u6709\u9884\u9632\u4f5c\u7528\uff0c\u4f46\u5e76\u4e0d\u80fd\u7f29\u77ed\u60a3\u8005ICU\u4f4f\u9662\u65f6\u95f4\u548c\u603b\u4f4f\u9662\u65f6\u95f4\uff0c\u4e5f\u4e0d\u80fd\u6539\u5584\u683c\u62c9\u65af\u54e5\u9884\u540e\u8bc4\u5206\uff08Glasgow outcome scale\uff0cGOS\uff09<sup>[130]<\/sup>\u30022019\u5e74\u4e00\u9879\u524d\u77bb\u6027RCT\u7814\u7a76\u663e\u793a\uff0c\u5728\u884c\u7ecf\u76ae\u6c14\u7ba1\u5207\u5f00\u672f\u7684\u795e\u5916\u91cd\u75c7\u60a3\u8005\u4e2d\u6301\u7eed\u8f93\u6ce8\u4f4e\u5242\u91cf\u53f3\u7f8e\u6258\u54aa\u5b9a\u8f83\u8212\u82ac\u592a\u5c3c\u53ef\u663e\u8457\u51cf\u5c11\u60a3\u8005\u672f\u4e2d\u79fb\u52a8\u7684\u6b21\u6570\u548c\u54b3\u55fd\u4e8b\u4ef6\uff0c\u964d\u4f4e\u9547\u75db\u9547\u9759\u836f\u7269\u8865\u6551\u5242\u91cf\u4ee5\u53ca\u5fc3\u52a8\u8fc7\u901f\u3001\u9ad8\u8840\u538b\u548c\u547c\u5438\u6291\u5236\u7684\u53d1\u751f\u7387\uff0c\u663e\u793a\u51fa\u5176\u5728\u6709\u521b\u64cd\u4f5c\u4e2d\u7684\u5e94\u7528\u4ef7\u503c<sup>[131]<\/sup>\u3002James\u7b49<sup>[132]<\/sup>\u6bd4\u8f83\u4e86\u4e19\u6cca\u915a\u4e0e\u53f3\u7f8e\u6258\u54aa\u5b9a\u5bf9\u673a\u68b0\u901a\u6c14\u8111\u635f\u4f24\u60a3\u8005\u7684\u8111\u751f\u7406\u5f71\u54cd\uff0c\u4e24\u8005\u5bf9\u8111\u751f\u7406\u5b66\u6307\u6807\u7684\u5f71\u54cd\u65e0\u663e\u8457\u5dee\u5f02\u4e14\u4e0e\u4e0d\u826f\u53cd\u5e94\u65e0\u5173\u30022014\u5e74Srivastava\u7b49<sup>[133]<\/sup>\u6bd4\u8f83\u4e86\u53f3\u7f8e\u6258\u54aa\u5b9a\u3001\u4e19\u6cca\u915a\u548c\u54aa\u8fbe\u5511\u4ed1\u5bf9\u672f\u540e\u673a\u68b0\u901a\u6c14\u7684\u795e\u7ecf\u5916\u79d1\u60a3\u8005\u7684\u77ed\u671f\u9547\u9759\u4f5c\u7528\uff0c\u7ed3\u679c\u8868\u660e\uff0c\u4e0e\u4e19\u6cca\u915a\u548c\u54aa\u8fbe\u5511\u4ed1\u76f8\u6bd4\uff0c\u53f3\u7f8e\u6258\u54aa\u5b9a\u662f\u66f4\u5b89\u5168\u548c\u540c\u6837\u6709\u6548\u7684\u836f\u7269\uff0c\u7528\u4e8e\u795e\u7ecf\u5916\u79d1\u673a\u68b0\u901a\u6c14\u60a3\u8005\u7684\u9547\u9759\uff0c\u8840\u6d41\u52a8\u529b\u5b66\u7a33\u5b9a\u6027\u597d\uff0c\u62d4\u7ba1\u65f6\u95f4\u4e0e\u4e19\u6cca\u915a\u6240\u9700\u65f6\u95f4\u4e00\u6837\uff0c\u53f3\u7f8e\u6258\u54aa\u5b9a\u4e5f\u51cf\u5c11\u4e86\u672f\u540e\u82ac\u592a\u5c3c\u7684\u9700\u6c42\u30022014\u5e74Erdman\u7b49<sup>[134]<\/sup>\u6bd4\u8f83\u4e86\u4f7f\u7528\u53f3\u7f8e\u6258\u54aa\u5b9a\u4e0e\u4e19\u6cca\u915a\u7684\u795e\u7ecf\u91cd\u75c7\u60a3\u8005\u4e25\u91cd\u8840\u6d41\u52a8\u529b\u5b66\u4e8b\u4ef6\u7684\u53d1\u751f\u7387\uff0c\u5728\u63a5\u53d7\u53f3\u7f8e\u6258\u54aa\u5b9a\u6216\u4e19\u6cca\u915a\u7684\u795e\u7ecf\u91cd\u75c7\u60a3\u8005\u4e2d\uff0c\u4e25\u91cd\u7684\u4f4e\u8840\u538b\u548c\u5fc3\u52a8\u8fc7\u7f13\u7684\u53d1\u751f\u7387\u76f8\u4f3c\u30022013\u5e74Wang\u7b49<sup>[135]<\/sup>\u7814\u7a76\u53d1\u73b0\uff0c\u53f3\u7f8e\u6258\u54aa\u5b9a\u53ef\u7528\u4e8eTBI\u60a3\u8005\u4e14\u65e0\u5f71\u54cd\u8111\u7ec4\u7ec7\u6c27\u5408\u7684\u98ce\u9669\u30022011\u5e74Yokota\u7b49<sup>[136]<\/sup>\u7684\u4e00\u9879\u56de\u987e\u6027\u89c2\u5bdf\u7814\u7a76\u663e\u793a\uff0c\u53f3\u7f8e\u6258\u54aa\u5b9a\u53ef\u4ee5\u5b89\u5168\u5730\u7528\u4e8e\u672a\u7834\u88c2\u9885\u5185\u52a8\u8109\u7624\u5f00\u9885\u672f\u540e\u63d2\u7ba1\u548c\u62d4\u7ba1\u7684\u60a3\u8005\uff0c\u4f46\u5176\u663e\u8457\u964d\u4f4e\u4e86\u5fc3\u7387\uff1b\u8be5\u7814\u7a76\u7ed3\u679c\u8fd8\u8868\u660e\uff0c\u5728\u7ba1\u7406\u63d2\u7ba1\u60a3\u8005\u65f6\uff0c\u6700\u597d\u5728\u53f3\u7f8e\u6258\u54aa\u5b9a\u7684\u57fa\u7840\u4e0a\u52a0\u7528\u4f4e\u5242\u91cf\u4e19\u6cca\u915a\u3002<\/p>\n<p>\u5bf9\u4e8e\u795e\u7ecf\u91cd\u75c7\u60a3\u8005\u7684\u4e34\u5e8a\u9884\u540e\u8bc4\u4f30\uff0c\u591a\u9879\u6bd4\u8f83\u54aa\u8fbe\u5511\u4ed1\u4e0e\u4e19\u6cca\u915a\u9547\u9759\u6548\u679c\u7684\u7814\u7a76\u663e\u793a\uff0cGOS\u8bc4\u5206\u3001\u75c5\u6b7b\u7387\u7b49\u7ec8\u70b9\u6307\u6807\u5747\u65e0\u663e\u8457\u5dee\u5f02<sup>[16\uff0c137\uff0c138]<\/sup>\u3002\u4ee5\u4e0a\u7814\u7a76\u8868\u660e\uff0c\u5e38\u7528\u7684\u51e0\u79cd\u9547\u9759\u836f\u7269\u5747\u53ef\u5728\u63a7\u5236ICP\u7684\u540c\u65f6\u4fdd\u8bc1\u5b89\u5168\u6027\u3002\u9700\u6ce8\u610f\u7684\u662f\uff0c2023\u5e74\u4e00\u9879\u835f\u8403\u5206\u6790\u8868\u660e\uff0c\u4e0e\u5176\u4ed6\u9547\u9759\u836f\u7269\u76f8\u6bd4\uff0c\u4e19\u6cca\u915a\u53ef\u80fd\u4f1a\u964d\u4f4e\u56f4\u624b\u672f\u671f\u548c\u5371\u91cd\u60a3\u8005\u7684\u751f\u5b58\u7387\uff0c\u4e14\u8be5\u98ce\u9669\u5e76\u4e0d\u80fd\u5f52\u56e0\u4e8e\u6025\u6027\u53cd\u5e94\uff08\u5982\u8fc7\u654f\uff09\u3002\u8be5\u7814\u7a76\u63d0\u793a\u5e94\u5bf9PRIS\u3001\u76f8\u5173\u611f\u67d3\u98ce\u9669\u3001\u5bf9\u5176\u4ed6\u5e72\u9884\u63aa\u65bd\u7684\u5668\u5b98\u4fdd\u62a4\u7684\u6291\u5236\u4f5c\u7528\u3001\u8840\u6d41\u52a8\u529b\u5b66\u4e0d\u7a33\u5b9a\u7b49\u52a0\u4ee5\u5173\u6ce8<sup>[139]<\/sup>\u3002<\/p>\n<\/p>\n<p>\u5728\u67d0\u4e9b\u7279\u6b8a\u60c5\u51b5\u4e0b\uff08\u8e81\u52a8\u3001\u8c35\u5984\u3001NWT\u7b49\uff09\uff0c\u4e0d\u540c\u836f\u7269\u663e\u793a\u51fa\u4e0d\u540c\u7684\u7279\u70b9\u3002\u4e00\u9879\u835f\u8403\u5206\u6790\u663e\u793a\uff0c\u5728\u5177\u4f53\u4e34\u5e8a\u73af\u5883\u4e2d\uff0c\u4e19\u6cca\u915a\u66f4\u5e38\u7528\u4e8e\u8e81\u52a8\u7ba1\u7406\uff0c\u53f3\u7f8e\u6258\u54aa\u5b9a\u66f4\u5e38\u7528\u4e8e\u795e\u7ecf\u7cfb\u7edf\u68c0\u67e5\u671f\u95f4\u52a0\u901f\u62d4\u7ba1\u3001\u9152\u7cbe\u6212\u65ad\u548c\u9547\u9759\u6cbb\u7597\uff0c\u4e19\u6cca\u915a\u7ec4\u75c5\u6b7b\u7387\u663e\u8457\u66f4\u9ad8\uff0c\u53f3\u7f8e\u6258\u54aa\u5b9a\u7ec4\u5165\u9662CGS\u8bc4\u5206\u5e73\u5747\u503c\u8f83\u9ad8<sup>[140]<\/sup>\u30022021\u5e74Burry\u7b49<sup>[141]<\/sup>\u4e00\u9879\u9488\u5bf9\u7efc\u5408ICU\u91cd\u75c7\u60a3\u8005\u7684\u7cfb\u7edf\u56de\u987e\u548c\u7f51\u72b6\u835f\u8403\u5206\u6790\u5bf9\u6bd4\u4e86\u9884\u9632\u91cd\u75c7\u60a3\u8005\u8c35\u5984\u7684\u836f\u7269\u4e0e\u975e\u836f\u7269\u5e72\u9884\u63aa\u65bd\uff0c\u7ed3\u679c\u663e\u793a\uff0c\u4ec5\u53f3\u7f8e\u6258\u54aa\u5b9a\u53ef\u80fd\u51cf\u5c11\u8c35\u5984\u7684\u53d1\u751f\u30022021\u5e74He\u7b49<sup>[142]<\/sup>\u8fdb\u884c\u7684\u4e00\u9879\u5355\u4e2d\u5fc3RCT\u7814\u7a76\u5171\u7eb3\u5165\u4e8660\u4f8b\u5f00\u9885\u672f\u540e\u5165\u4f4fICU\u7684\u6210\u4eba\u60a3\u8005\uff0c\u7ed3\u679c\u663e\u793a\uff0c\u4f4e\u5242\u91cf\u53f3\u7f8e\u6258\u54aa\u5b9a\u53ef\u5b89\u5168\u5730\u7528\u4e8e\u5f00\u9885\u672f\u540e\u60a3\u8005\u7684\u8c35\u5984\u9884\u9632\uff0c\u4f46\u5728\u8c35\u5984\u7684\u53d1\u751f\u7387\u65b9\u9762\u672a\u663e\u793a\u51fa\u663e\u8457\u5dee\u5f02\u3002<\/p>\n<p>\u65b0\u578b\u9547\u9759\u836f\u7269\u73af\u6cca\u915a\u3001\u745e\u9a6c\u5511\u4ed1\u5df2\u6709\u5728\u7efc\u5408ICU\u7684\u5e94\u7528\u6570\u636e\u30022023\u5e74\uff0cLiu\u7b49<sup>[143]<\/sup>\u7684\u4e00\u9879\u591a\u4e2d\u5fc3RCT\u7814\u7a76\u663e\u793a\uff0c\u4e0e\u4e19\u6cca\u915a\u76f8\u6bd4\uff0c\u73af\u6cca\u915a\u9547\u9759\u6210\u529f\u7387\u76f8\u5f53\uff0c\u6062\u590d\u65f6\u95f4\u663e\u8457\u5ef6\u957f\uff08min\uff1a4.8\u00b19.8\u6bd41.6\u00b12.8\uff0cP\uff1d0.003\uff09\uff1b\u6cbb\u7597\u540e\u51fa\u73b0\u4e0d\u826f\u4e8b\u4ef6\uff08treatment emergent adverse event\uff0cTEAE\uff09\u53ca\u836f\u7269\u76f8\u5173TEAE\u7684\u53d1\u751f\u7387\u5728\u4e24\u7ec4\u95f4\u5dee\u5f02\u5747\u65e0\u7edf\u8ba1\u5b66\u610f\u4e49\uff0863.3%\u6bd475.6%\uff0c24.4%\u6bd435.6%\uff0c\u5747P&gt;0.05\uff09\u30022022\u5e74Tang\u7b49<sup>[144]<\/sup>\u7684\u4e00\u9879\u5355\u4e2d\u5fc3\u968f\u673a\u9884\u7814\u7a76\u663e\u793a\uff0c\u4e0e\u4e19\u6cca\u915a\u76f8\u6bd4\uff0c\u745e\u9a6c\u5511\u4ed1\u9547\u9759\u8fbe\u6807\u7387\u76f8\u5f53\uff0869.3%\u6bd467.8%\uff0cP\uff1d0.269\uff09\uff0c\u65e0\u8865\u6551\u9547\u9759\u7684\u65f6\u95f4\u767e\u5206\u6bd4\u76f8\u5f53\u301482.8%\uff0865.6%\uff0c100%\uff09\u6bd473.2%\uff0841.5%\uff0c97.3%\uff09\uff0cP\uff1d0.269\u3015\uff0c\u4e24\u7ec4\u4e4b\u95f4\u9884\u540e\u6307\u6807\u53ca\u5fc3\u8840\u7ba1\u4e8b\u4ef6\uff08\u4f4e\u8840\u538b\u548c\u5fc3\u52a8\u8fc7\u901f\uff09\u65e0\u663e\u8457\u5dee\u5f02\u3002<\/p>\n<p>\u63a8\u8350\u610f\u89c121\uff1a\u5bf9\u4e8e\u795e\u7ecf\u91cd\u75c7\u60a3\u8005\u9547\u75db\u9547\u9759\u836f\u7269\u7684\u9009\u62e9\u76ee\u524d\u5c1a\u65e0\u6700\u4f18\u7b56\u7565\u3002\u963f\u7247\u7c7b\u836f\u7269\u3001\u54aa\u8fbe\u5511\u4ed1\u548c\u4e19\u6cca\u915a\u662f\u6700\u5e38\u7528\u7684\u9547\u75db\u9547\u9759\u836f\u7269\u3002\uff08\u5171\u8bc6\u5ea6\uff1a100%\uff1b36\/36\uff09<\/p>\n<p>\u63a8\u8350\u610f\u89c122\uff1a\u5e94\u57fa\u4e8e\u60a3\u8005\u7279\u70b9\u3001\u6cbb\u7597\u9700\u6c42\u4ee5\u53ca\u836f\u7269\u836f\u7406\u5b66\u7279\u70b9\u9009\u62e9\u9547\u75db\u9547\u9759\u836f\u7269\u3002\u5e94\u7528\u9547\u75db\u9547\u9759\u836f\u7269\uff08\u7279\u522b\u662f\u963f\u7247\u7c7b\u836f\u7269\uff09\u9700\u8b66\u60d5\u836f\u7269\u4e0d\u826f\u53cd\u5e94\uff0c\u5982\u547c\u5438\u6291\u5236\u3001\u4f4e\u8840\u538b\u3001\u5bf9\u610f\u8bc6\u7684\u5f71\u54cd\u3001\u836f\u7269\u8010\u53d7\u548c\u6212\u65ad\u7efc\u5408\u5f81\u7b49\uff0c\u5c24\u5176\u5728\u7279\u6b8a\u4eba\u7fa4\u4e2d\uff08\u5982\u8840\u6d41\u52a8\u529b\u5b66\u4e0d\u7a33\u5b9a\u3001\u809d\u80be\u529f\u80fd\u4e0d\u5168\u3001\u8001\u5e74\u6216\u80a5\u80d6\u60a3\u8005\uff09\u3002\uff08\u5171\u8bc6\u5ea6\uff1a100%\uff1b36\/36\uff09<\/p>\n<p>\u63a8\u8350\u610f\u89c123\uff1a\u5f53\u6709\u51c6\u786e\u3001\u5feb\u901f\u8bc4\u4f30\u795e\u7ecf\u91cd\u75c7\u60a3\u8005\u795e\u7ecf\u529f\u80fd\u7684\u9700\u6c42\u65f6\uff0c\u77ed\u6548\/\u8d85\u77ed\u6548\u9547\u75db\u9547\u9759\u836f\u7269\u53ef\u80fd\u662f\u66f4\u5408\u9002\u7684\u9009\u62e9\u3002\uff08\u5171\u8bc6\u5ea6\uff1a100%\uff1b36\/36\uff09<\/p>\n<p>\u63a8\u8350\u610f\u89c124\uff1a\u795e\u7ecf\u91cd\u75c7\u60a3\u8005\u5e94\u8c28\u614e\u4f7f\u7528\u6c2f\u80fa\u916e\u3002\uff08\u5171\u8bc6\u5ea6\uff1a94.4%\uff1b34\/36\uff09<\/p>\n<p>\u63a8\u8350\u610f\u89c125\uff1a\u53f3\u7f8e\u6258\u54aa\u5b9a\u9884\u9632\u548c\u6cbb\u7597\u795e\u7ecf\u91cd\u75c7\u60a3\u8005\u8c35\u5984\u7684\u6709\u6548\u6027\u6709\u5f85\u8fdb\u4e00\u6b65\u8bc1\u5b9e\u3002\uff08\u5171\u8bc6\u5ea6\uff1a94.4%\uff1b34\/36\uff09<\/p>\n<\/p>\n<p>6\u3000\u9547\u75db\u9547\u9759\u6cbb\u7597\u5728RIH\u4e2d\u7684\u5e94\u7528<\/p>\n<p>\u4e34\u5e8a\u95ee\u989815\uff1a\u795e\u7ecf\u91cd\u75c7\u60a3\u8005\u51fa\u73b0RIH\u65f6\uff0c\u662f\u5426\u5e94\u5f3a\u5316\u9547\u75db\u9547\u9759\u6cbb\u7597\uff1f<\/p>\n<p>\u80cc\u666f\uff1aIH\u662f\u795e\u7ecf\u91cd\u75c7\u60a3\u8005\u7684\u4e25\u91cd\u5e76\u53d1\u75c7\uff0c\u6301\u7eedIH\u53ef\u5bfc\u81f4\u8111\u7ec4\u7ec7\u704c\u6ce8\u4e0d\u8db3\uff0c\u5f15\u8d77\u7f3a\u8840\u7f3a\u6c27\uff0c\u52a0\u91cd\u8111\u635f\u4f24\uff0c\u4e25\u91cd\u60c5\u51b5\u4e0b\u53ef\u53d1\u751f\u8111\u759d\u5371\u53ca\u751f\u547d\u3002\u56e0\u6b64\uff0c\u79ef\u6781\u63a7\u5236ICP\u662f\u9884\u9632\u548c\u51cf\u5c11\u7ee7\u53d1\u6027\u8111\u635f\u4f24\u7684\u5173\u952e\u73af\u8282\u30022017\u5e74\u7f8e\u56fd\u7b2c4\u7248sTBI\u7ba1\u7406\u6307\u5357\u30012019\u5e74SIBICC\u7b49\u660e\u786e\uff0cIH\u65f6\u5e94\u91c7\u53d6\u9636\u68af\u5f0f\u7b56\u7565\uff08T1~T3\uff09\uff0c\u5c3d\u7ba1\u76ee\u524d\u5c1a\u65e0\u8db3\u591f\u591a\u7684\u8bc1\u636e\u652f\u6301\u67d0\u4e00\u79cd\u6cbb\u7597\u63aa\u65bd\u80fd\u591f\u5fc5\u7136\u6539\u5584\u60a3\u8005\u7684\u4e34\u5e8a\u7ed3\u5c40\uff0c\u4f46\u5176\u4e00\u81f4\u76ee\u7684\u5747\u662f\u63a7\u5236IH\uff0c\u7ef4\u6301\u8db3\u591f\u7684\u8111\u704c\u6ce8<sup>[13\uff0c14]<\/sup>\u3002<\/p>\n<p>\u75bc\u75db\u3001\u8e81\u52a8\u7b49\u60c5\u51b5\u53ef\u5bfc\u81f4ICP\u5347\u9ad8\uff0c\u56e0\u6b64\u9547\u75db\u9547\u9759\u6cbb\u7597\u662f\u6cbb\u7597IH\u4e2d\u7684\u4e00\u4e2a\u57fa\u7840\u90e8\u5206\u3002\u5e38\u89c4\u7597\u6cd5\u65e0\u6548\u7684IH\u72b6\u6001\u79f0\u4e3aRIH<sup>[145]<\/sup>\u3002\u5f53\u5904\u4e8eRIH\u72b6\u6001\u65f6\uff0c\u4e3a\u63a7\u5236ICP\u800c\u4e0d\u5f97\u4e0d\u589e\u52a0\u9547\u75db\u9547\u9759\u836f\u7269\u5242\u91cf\uff0c\u6b64\u65f6\u836f\u7269\u7684\u5b89\u5168\u6027\u9700\u8981\u91cd\u89c6\uff0c\u5e94\u8003\u8651\u8054\u5408\u5176\u4ed6\u964d\u4f4eICP\u7684\u63aa\u65bd\u3002<\/p>\n<p>\u8bc1\u636e\u603b\u7ed3\uff1a\u8fd1\u5e74\u6765\u6709\u5173RIH\u9547\u75db\u9547\u9759\u6cbb\u7597\u7684\u8bc1\u636e\u8f83\u5c11\u30022019\u5e74Schomer\u7b49<sup>[128]<\/sup>\u53d1\u73b0\uff0c\u53f3\u7f8e\u6258\u54aa\u5b9a\u7528\u4e8eRIH\u7684\u8f85\u52a9\u6cbb\u7597\uff0c\u53ef\u907f\u514d\u633d\u6551\u6027\u6cbb\u7597\u9700\u6c42\uff08\u9ad8\u6e17\u900f\u6cbb\u7597\u3001\u8111\u5ba4\u5916\u5f15\u6d41\uff09\u7684\u589e\u52a0\uff0c\u5e76\u4e14\u5728\u795e\u7ecf\u5371\u91cd\u75c7\u60a3\u8005\u4e2d\u4f7f\u7528\u5177\u6709\u5b89\u5168\u7684\u836f\u6548\u5b66\u7279\u5f81\u3002<\/p>\n<p>\u7f8e\u56fd\u7b2c4\u7248sTBI\u7ba1\u7406\u6307\u5357\u63d0\u51fa\u4e19\u6cca\u915a\u662f\u4e00\u79cd\u5f3a\u6548\u5fc3\u8840\u7ba1\u6291\u5236\u5242\uff0c\u5f53\u5927\u5242\u91cf\u3001\u957f\u65f6\u95f4\u4f7f\u7528\u65f6\u9700\u76d1\u6d4b\u836f\u7269\u7684\u5b89\u5168\u6027\uff0c\u4ee5\u9632PRIS\uff1b\u5f53TBI\u4ee5\u5916\u7684\u795e\u7ecf\u91cd\u75c7\u60a3\u8005\u51fa\u73b0RIH\u65f6\uff0c\u4e5f\u53ef\u501f\u9274\u8be5\u6307\u5357\u7684\u5185\u5bb9\u8fdb\u884c\u5b9e\u8df5\u7ba1\u7406<sup>[14]<\/sup>\u3002<\/p>\n<p>\u63a8\u8350\u610f\u89c126\uff1a\u795e\u7ecf\u91cd\u75c7\u60a3\u8005\u51fa\u73b0RIH\u65f6\uff0c\u5e94\u5f3a\u5316\u9547\u75db\u9547\u9759\u6cbb\u7597\u3002\uff08\u5171\u8bc6\u5ea6\uff1a97.2%\uff1b35\/36\uff09<\/p>\n<p>\u63a8\u8350\u610f\u89c127\uff1a\u5e94\u7528\u5927\u5242\u91cf\u9547\u9759\u836f\u7269\u65f6\u9700\u8b66\u60d5\u836f\u7269\u4e0d\u826f\u53cd\u5e94\uff0c\u5982PRIS\u7b49\u3002\uff08\u5171\u8bc6\u5ea6\uff1a100%\uff1b36\/36\uff09<\/p>\n<\/p>\n<p>\u4e34\u5e8a\u95ee\u989816\uff1a\u795e\u7ecf\u91cd\u75c7\u60a3\u8005\u51fa\u73b0RIH\u65f6\u662f\u5426\u63a8\u8350\u4f7f\u7528\u5df4\u6bd4\u59a5\u7c7b\u836f\u7269\uff1f<\/p>\n<p>\u80cc\u666f\uff1a\u5bf9\u4e8e\u5176\u4ed6\u4fdd\u5b88\u6cbb\u7597\u65e0\u6548\u7684IH\uff0c\u6216\u8005\u4f5c\u4e3a\u53bb\u9aa8\u74e3\u51cf\u538b\u672f\uff08decompressed craniectomy\uff0cDC\uff09\u6cbb\u7597\u524d\u7684\u62a2\u6551\u624b\u6bb5\uff0c\u5df4\u6bd4\u59a5\u7c7b\u836f\u7269\u53ef\u4f5c\u4e3a\u66f4\u4e3a\u79ef\u6781\u7684\u6cbb\u7597\u624b\u6bb5\u3002\u5df4\u6bd4\u59a5\u7c7b\u836f\u7269\u53ef\u964d\u4f4e\u8111\u4ee3\u8c22\u548c\u8111\u8840\u6d41\u91cf\uff0c\u6539\u5584\u8111\u7ec4\u7ec7\u6c27\u5408\u6c34\u5e73\u3002\u4f46\u7531\u4e8e\u5df4\u6bd4\u59a5\u7c7b\u836f\u7269\u4ee3\u8c22\u65f6\u95f4\u957f\u7684\u7279\u70b9\uff0c\u60a3\u8005\u4e5f\u9762\u4e34\u7740\u65e0\u6cd5\u8fdb\u884c\u66f4\u4e3a\u9891\u7e41\u7684\u795e\u7ecf\u529f\u80fd\u8bc4\u4f30\u4ee5\u53d1\u73b0\u6f5c\u5728\u7684\u65b0\u53d1\u75c5\u53d8\u7b49\u98ce\u9669\u3002\u56e0\u6b64\uff0c\u672a\u6765\u4ecd\u9700\u66f4\u591a\u7684\u9ad8\u8d28\u91cf\u7814\u7a76\u5bf9RIH\u60a3\u8005\u7684\u6cbb\u7597\u548c\u4e34\u5e8a\u8f6c\u5f52\u8fdb\u884c\u63a2\u7d22\u3002<\/p>\n<p>\u8bc1\u636e\u603b\u7ed3\uff1aRoberts\u548cSydenham<sup>[146]<\/sup>\u7684\u4e00\u9879\u7cfb\u7edf\u8bc4\u4ef7\u5206\u6790\u4e866\u9879RCT\uff0c\u5c3d\u7ba1\u6ca1\u6709\u8bc1\u636e\u8868\u660e\u5df4\u6bd4\u59a5\u7c7b\u836f\u7269\u53ef\u4ee5\u6539\u5584RIH\u60a3\u8005\u7684\u9884\u540e\uff0c\u4f46\u5df4\u6bd4\u59a5\u7c7b\u836f\u7269\u53ef\u63a7\u5236\u90e8\u5206\u6025\u6027TBI\u60a3\u8005\u7684ICP\u3002\u9700\u8981\u6ce8\u610f\u7684\u662f\uff0c\u5373\u4fbf\u5df4\u6bd4\u59a5\u7c7b\u836f\u7269\u53ef\u4ee5\u964d\u4f4eICP\uff0c\u4f46\u5176\u540c\u65f6\u4e5f\u6709\u5bfc\u81f4\u4f4e\u8840\u538b\u7684\u98ce\u9669\u3002Marshall\u7b49<sup>[147]<\/sup>\u7684\u56de\u987e\u6027\u7814\u7a76\u8868\u660e\uff0c\u5df4\u6bd4\u59a5\u7c7b\u836f\u7269\u6cbb\u7597\u662f\u5728\u5e38\u89c4\u6cbb\u7597\u548c\u8111\u810a\u6db2\u5f15\u6d41\u672a\u80fd\u63a7\u5236ICP\u7684\u60c5\u51b5\u4e0b\u542f\u52a8\uff0c\u4f46\u8be5\u4e2d\u5fc3\u63a5\u53d7\u620a\u5df4\u6bd4\u59a5\u660f\u8ff7\uff08pentobarbital coma\uff0cPBC\uff09\u6cbb\u7597\u7684\u60a3\u8005\u4ec5\u53601.1%\uff0858\/4 934\uff09\u3002Ryu\u7b49<sup>[148]<\/sup>\u7684\u7814\u7a76\u4e2d\uff0c\u8111\u80bf\u7624\u5207\u9664\u672f\u540e\u63a5\u53d7\u5df4\u6bd4\u59a5\u9178\u76d0\u660f\u8ff7\u7597\u6cd5\uff08barbiturate coma therapy\uff0cBCT\uff09\u7684\u60a3\u8005\u540c\u6837\u6bd4\u4f8b\u5f88\u4f4e\uff0c\u4ec5\u53601.7%\uff0873\/4 296\uff09\uff0c\u5f53BCT\u6cbb\u7597\u540e6 h\u5185ICP\u4ecd\u9ad8\u4e8e22 mmHg\u662fBCT\u540e\u6b7b\u4ea1\u7684\u91cd\u8981\u9884\u6d4b\u56e0\u7d20\u30022021\u5e74Kajiwara\u7b49<sup>[149]<\/sup>\u7684\u7814\u7a76\u4e5f\u53d1\u73b0\uff0c\u9884\u9632\u6027\u5df4\u6bd4\u59a5\u9178\u76d0\u7597\u6cd5\u5177\u6709\u63a7\u5236ICP\u5347\u9ad8\u7684\u4f5c\u7528\u3002<\/p>\n<p>\u63a8\u8350\u610f\u89c128\uff1a\u5bf9\u5176\u4ed6\u4fdd\u5b88\u63aa\u65bd\u6cbb\u7597\u65e0\u6548\u7684RIH\u60a3\u8005\u53ef\u4f7f\u7528\u5df4\u6bd4\u59a5\u7c7b\u836f\u7269\u3002\uff08\u5171\u8bc6\u5ea6\uff1a91.7%\uff1b33\/36\uff09<\/p>\n<\/p>\n<p>7\u3000\u9547\u75db\u9547\u9759\u6cbb\u7597\u5728TTM\u4e2d\u7684\u5e94\u7528<\/p>\n<p>\u4e34\u5e8a\u95ee\u989817\uff1a\u795e\u7ecf\u91cd\u75c7\u60a3\u8005TTM\u65f6\u9547\u75db\u9547\u75db\u836f\u7269\u5982\u4f55\u9009\u62e9\uff1f<\/p>\n<p>\u4e34\u5e8a\u95ee\u989818\uff1a\u5bf9\u4e8e\u795e\u7ecf\u91cd\u75c7\u60a3\u8005\u7684TTM\uff0c\u662f\u5426\u63a8\u8350\u8f85\u52a9\u4f7f\u7528\u795e\u7ecf\u808c\u8089\u963b\u6ede\u836f\u7269\uff1f<\/p>\n<p>\u80cc\u666f\uff1aTTM\u5e38\u7528\u4e8e\u5fc3\u640f\u9aa4\u505c\u540e\u795e\u7ecf\u7cfb\u7edf\u635f\u4f24\u3001sTBI\u3001SAH\u3001\u5927\u9762\u79ef\u8111\u6897\u6b7b\u4ee5\u53ca\u766b\u75eb\u6301\u7eed\u72b6\u6001\u7b49\u60c5\u51b5\u4ee5\u9884\u9632\u7ee7\u53d1\u6027\u8111\u635f\u4f24\uff0c\u6cbb\u7597\u987d\u56fa\u6027IH\u3002TTM\u53ef\u4ee5\u964d\u4f4e\u8111\u4ee3\u8c22\uff0c\u8c03\u8282\u8111\u8840\u6d41\u91cf\uff0c\u51cf\u8f7b\u8111\u6c34\u80bf\u5e76\u964d\u4f4eICP\u3002Chen\u7b49<sup>[22]<\/sup>\u7684\u4e00\u9879\u835f\u8403\u5206\u6790\u7eb3\u516523\u9879\u7814\u7a76\uff0c\u7ed3\u679c\u663e\u793a\uff0c\u572824 h\u5185\u542f\u52a8TH\u53ef\u4ee5\u4f7fTBI\u60a3\u8005\u83b7\u76ca\u3002\u7136\u800c\uff0c\u7531\u4e8e\u4e2d\u6df1\u5ea6\u4f4e\u6e29\u53ef\u80fd\u4f1a\u4f34\u968f\u6f5c\u5728\u98ce\u9669\uff0c\u4e14\u73b0\u6709\u7684\u5faa\u8bc1\u533b\u5b66\u8bc1\u636e\u4e0d\u8db3\u4ee5\u652f\u6301\u5176\u795e\u7ecf\u4fdd\u62a4\u4f5c\u7528\uff0c\u5982Andrews\u7b49<sup>[150]<\/sup>\u7684RCT\u7814\u7a76\u7ed3\u679c\u867d\u7136\u5c06\u4f4e\u6e29\u4f5c\u4e3a\u63a7\u5236ICP\u7684\u4e00\u7ebf\u63aa\u65bd\uff0c\u4f46\u8003\u8651\u5230\u5176\u6cbb\u7597\u8fc7\u7a0b\u4e2d\u7684\u4e25\u91cd\u5e76\u53d1\u75c7\uff08\u5982\u5bd2\u6218\u3001\u4f4e\u8840\u538b\u7b49\uff09\uff0c\u5e76\u4e14\u5bf9\u91cd\u75c7\u60a3\u8005\u672a\u89c2\u5bdf\u5230\u660e\u663e\u7684\u4e34\u5e8a\u83b7\u76ca\uff0c\u56e0\u6b64\u4ecd\u9700\u66f4\u591a\u6709\u5173TTM\u7684\u9ad8\u8d28\u91cf\u5faa\u8bc1\u533b\u5b66\u8bc1\u636e\u6765\u652f\u6301\u8fdb\u4e00\u6b65\u7684\u4e34\u5e8a\u63a8\u5e7f\u3002<\/p>\n<p>TTM\u7684\u5b9e\u65bd\u5e38\u901a\u8fc7\u7269\u7406\u964d\u6e29\u8054\u5408\u836f\u7269\u7684\u624b\u6bb5\u63a7\u5236\u6838\u5fc3\u6e29\u5ea6\uff0c\u5177\u4f53\u6d41\u7a0b\u548c\u76f8\u5173\u6ce8\u610f\u4e8b\u9879\u53ef\u53c2\u89c1\u300a\u795e\u7ecf\u91cd\u75c7\u76ee\u6807\u6e29\u5ea6\u7ba1\u7406\u4e2d\u56fd\u4e13\u5bb6\u5171\u8bc6\uff082022\u7248\uff09\u300b<sup>[151]<\/sup>\u3002\u503c\u5f97\u5f3a\u8c03\u7684\u662f\uff0cTTM\u4e0e\u5bd2\u6218\u6709\u5173\uff0c\u5bfc\u81f4\u673a\u4f53\u4ee3\u8c22\u53ca\u6c27\u8017\u589e\u52a0\uff0c\u800c\u9547\u75db\u9547\u9759\u6cbb\u7597\u662f\u91cd\u8981\u7684\u836f\u7269\u8f85\u52a9\u624b\u6bb5\uff0c\u751a\u81f3\u8054\u7528\u795e\u7ecf\u808c\u8089\u963b\u6ede\u836f\u7269\u7f13\u89e3\u5bd2\u6218\u3002\u5728\u8bf1\u5bfc\u3001\u7ef4\u6301\u3001\u590d\u6e29\u9636\u6bb5\uff0c\u5e94\u4e0d\u65ad\u8c03\u6574\u9547\u75db\u9547\u9759\uff08\u5305\u62ec\u795e\u7ecf\u808c\u8089\u963b\u6ede\u836f\u7269\uff09\u65b9\u6848\u4ee5\u8fbe\u5230\u6700\u4f73\u7684\u6cbb\u7597\u6548\u679c\u3002\u76ee\u524d\u4e3a\u6b62\uff0cTTM\u7814\u7a76\u65b9\u6848\u5dee\u5f02\u5316\u660e\u663e\uff0c\u77ed\u6548\u836f\u7269\u5982\u4e19\u6cca\u915a\u548c\u745e\u82ac\u592a\u5c3c\u7b49\u7406\u8bba\u4e0a\u53ef\u80fd\u51cf\u5c11\u836f\u7269\u84c4\u79ef\u53ca\u907f\u514d\u5ef6\u8fdf\u82cf\u9192\uff0c\u4f46\u672a\u68c0\u7d22\u5230\u5bf9\u6bd4\u4e0d\u540c\u9547\u75db\u9547\u9759\u65b9\u6848\u5bf9\u9884\u540e\u5f71\u54cd\u7684\u76f8\u5173\u7814\u7a76\uff0c\u56e0\u6b64\u5c1a\u65e0\u6700\u4f73\u9547\u75db\u9547\u9759\u836f\u7269\u5728TTM\u4e2d\u7684\u63a8\u8350\u610f\u89c1\u3002<\/p>\n<p>\u8bc1\u636e\u603b\u7ed3\uff1a\u300a\u6b27\u6d32\u590d\u82cf\u59d4\u5458\u4f1a\u548c\u6b27\u6d32\u5371\u91cd\u75c5\u533b\u5b66\u4f1a\u6307\u53572021\uff1a\u5fc3\u80ba\u590d\u82cf\u540e\u6cbb\u7597\u300b\u63d0\u51fa\uff0c\u5bf9\u4e8eCPR\u540e\u81ea\u4e3b\u5faa\u73af\u6062\u590d\uff08return of spontaneous circulation\uff0cROSC\uff09\u4ecd\u65e0\u53cd\u5e94\u7684\u6210\u4eba\u63a8\u8350\u4f7f\u7528TTM\uff0c\u8fd9\u5176\u4e2d\u6d89\u53ca\u9547\u75db\u9547\u9759\u6cbb\u7597<sup>[152]<\/sup>\u3002\u8003\u8651\u5230TTM\u65f6\u836f\u7269\u4ee3\u8c22\u7684\u53d8\u5316\uff0c\u5efa\u8bae\u4f7f\u7528\u77ed\u6548\u9547\u9759\u5242\u548c\u963f\u7247\u7c7b\u836f\u7269\u3002\u5bf9\u4e8e\u795e\u7ecf\u808c\u8089\u963b\u6ede\u836f\u7269\u7684\u76ca\u5904\u591a\u5728\u6025\u6027\u547c\u5438\u7a98\u8feb\u7efc\u5408\u5f81\uff08acute respiratory distress syndrome\uff0cARDS\uff09\u60a3\u8005\u7684\u7814\u7a76\u4e2d\u88ab\u8bc1\u5b9e\uff0c\u800c\u5728TTM\u65f6\u795e\u7ecf\u808c\u8089\u963b\u6ede\u836f\u7269\u7684\u8bc1\u636e\u4e0d\u8db3\uff0c\u5e94\u907f\u514d\u5e38\u89c4\u4f7f\u7528\u795e\u7ecf\u808c\u8089\u963b\u6ede\u836f\u7269\uff0c\u4f46\u5728TTM\u671f\u95f4\u51fa\u73b0\u5bd2\u6218\u65f6\u53ef\u8003\u8651\u4f7f\u7528\u3002<\/p>\n<\/p>\n<p>\u5de5\u4f5c\u7ec4\u6c47\u603b\u4e86\u5173\u4e8eTTM\u76844\u7bc7\u835f\u8403\u5206\u6790<sup>[21\uff0c22\uff0c153\uff0c154]<\/sup>\u4ee5\u53ca\u5176\u4ed6RCT\u548c\u89c2\u5bdf\u6027\u7814\u7a76<sup>[23\uff0c155\uff0c156\uff0c157]<\/sup>\u5171\u8ba177\u9879\uff0c\u5176\u4e2d\u670917\u9879\u7814\u7a76\u672a\u62a5\u9053\u9547\u75db\u3001\u9547\u9759\u6216\u795e\u7ecf\u808c\u8089\u963b\u6ede\u836f\u7269\u6cbb\u7597\u65b9\u6848\uff1b\u53e6\u591660\u9879\u7814\u7a76\u4e2d\uff0c35\u9879\u7814\u7a76\u62a5\u9053\u4e86\u9547\u75db\u6cbb\u7597\u65b9\u6848\uff0c\u5176\u4e2d\u4ee5\u82ac\u592a\u5c3c\u6700\u4e3a\u5e38\u89c1\uff0826\u9879\uff09\uff1b49\u9879\u7814\u7a76\u62a5\u9053\u4e86\u9547\u9759\u6cbb\u7597\u65b9\u6848\uff0c\u5176\u4e2d\u4ee5\u54aa\u8fbe\u5511\u4ed1\uff0833\u9879\uff09\u548c\u4e19\u6cca\u915a\uff0812\u9879\uff09\u6700\u4e3a\u5e38\u89c1\u300250\u9879\u6d89\u53ca\u795e\u7ecf\u808c\u8089\u963b\u6ede\u836f\u7269\u7684\u7814\u7a76\u4e2d\uff0c\u5e38\u89c1\u836f\u7269\u4e3a\u6cee\u5e93\u6eb4\u94f5\uff0817\u9879\uff09\u3001\u987a\u5f0f\u963f\u66f2\u5e93\u94f5\uff0810\u9879\uff09\u4ee5\u53ca\u7ef4\u5e93\u6eb4\u94f5\uff087\u9879\uff09\uff0c\u5176\u4ed6\u8fd8\u5305\u62ec\u7f57\u5e93\u6eb4\u94f5\u3001\u963f\u66f2\u5e93\u94f5\u3001\u8bfa\u5e93\u6eb4\u94f5\u3002\u53e6\u5916\u8fd8\u67095\u9879\u7814\u7a76\u4f7f\u7528\u4e86\u51ac\u7720\u5408\u5242\u3002<\/p>\n<p>\u63a8\u8350\u610f\u89c129\uff1a\u5e94\u57fa\u4e8e\u60a3\u8005\u7279\u70b9\u3001\u6cbb\u7597\u9700\u6c42\u4ee5\u53ca\u836f\u7269\u836f\u7406\u5b66\u7279\u70b9\u9009\u62e9\u9547\u75db\u9547\u9759\u836f\u7269\u8fdb\u884cTTM\uff0c\u9274\u4e8e\u4f4e\u6e29\u65f6\u836f\u7269\u4ee3\u8c22\u548c\u6d88\u9664\u51cf\u6162\u3001\u4f5c\u7528\u65f6\u95f4\u5ef6\u957f\uff0c\u6b64\u65f6\u77ed\u6548\u9547\u75db\u9547\u9759\u836f\u7269\u53ef\u80fd\u662f\u66f4\u5408\u9002\u7684\u9009\u62e9\u3002\uff08\u5171\u8bc6\u5ea6\uff1a97.2%\uff1b35\/36\uff09<\/p>\n<p>\u63a8\u8350\u610f\u89c130\uff1a\u76ee\u524d\u5c1a\u65e0\u8bc1\u636e\u652f\u6301\u4f55\u79cd\u9547\u75db\u9547\u9759\u836f\u7269\u6700\u9002\u7528\u4e8e\u795e\u7ecf\u91cd\u75c7\u60a3\u8005\u7684TTM\u3002\u82ac\u592a\u5c3c\u3001\u54aa\u8fbe\u5511\u4ed1\u548c\u4e19\u6cca\u915a\u662f\u6700\u4e3a\u5e38\u7528\u7684\u9547\u75db\u9547\u9759\u836f\u7269\u3002\uff08\u5171\u8bc6\u5ea6\uff1a100%\uff1b36\/36\uff09<\/p>\n<p>\u63a8\u8350\u610f\u89c131\uff1a\u5bf9\u4e8e\u795e\u7ecf\u91cd\u75c7\u60a3\u8005\u7684TTM\uff0c\u907f\u514d\u5e38\u89c4\u4f7f\u7528\u795e\u7ecf\u808c\u8089\u963b\u6ede\u836f\u7269\u3002\uff08\u5171\u8bc6\u5ea6\uff1a100%\uff1b36\/36\uff09<\/p>\n<\/p>\n<p>\u672c\u5171\u8bc6\u5728\u5236\u8ba2\u8fc7\u7a0b\u4e2d\u9075\u5faa\u7f8e\u56fd\u533b\u5b66\u79d1\u5b66\u9662\uff08Institution of 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\u4e2d\u56fd\u75c5\u7406\u751f\u7406\u5b66\u4f1a\u5371\u91cd\u75c5\u533b\u5b66\u4e13\u4e1a\u59d4\u5458\u4f1a, \u300a\u795e\u7ecf\u91cd\u75c7\u60a3\u8005\u9547\u75db\u9547\u9759\u6cbb\u7597\u4e2d\u56fd\u4e13\u5bb6\u5171\u8bc6\u300b\u5de5\u4f5c\u7ec4. \u795e\u7ecf\u91cd\u75c7\u60a3\u8005\u9547\u75db\u9547\u9759\u6cbb\u7597\u4e2d\u56fd\u4e13\u5bb6\u5171\u8bc6\uff082023\uff09 [J] . \u4e2d\u534e\u5371\u91cd\u75c5\u6025\u6551\u533b\u5b66, 2023, 35(9) : 897-918.<\/p>\n<p>\u5e08\u5144\u548c\u4ffa\u5efa\u7acb\u4e86\u8d44\u5206\u4eab\u7fa4\uff0c\u9080\u60a8\u4e92\u76f8\u4ea4\u6d41\uff0c\u5fae\u4fe1gabstudy<\/p>\n","protected":false},"excerpt":{"rendered":"<p>\u795e\u7ecf\u91cd\u75c7\u60a3\u8005\u9547\u75db\u9547\u9759\u6cbb\u7597\u4e2d\u56fd\u4e13\u5bb6\u5171\u8bc6 \u9547\u75db\u9547\u9759\u6cbb\u7597\u5728\u91cd\u75c7\u533b\u5b66\u4e2d\u5177\u6709\u91cd\u8981\u4f5c\u7528\uff0c\u5728\u795e &hellip; <a href=\"http:\/\/zydq.1006ss.com\/?p=29694\">\u7ee7\u7eed\u9605\u8bfb <span class=\"meta-nav\">&rarr;<\/span><\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[70],"tags":[],"class_list":["post-29694","post","type-post","status-publish","format-standard","hentry","category-70"],"_links":{"self":[{"href":"http:\/\/zydq.1006ss.com\/index.php?rest_route=\/wp\/v2\/posts\/29694","targetHints":{"allow":["GET"]}}],"collection":[{"href":"http:\/\/zydq.1006ss.com\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"http:\/\/zydq.1006ss.com\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"http:\/\/zydq.1006ss.com\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"http:\/\/zydq.1006ss.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=29694"}],"version-history":[{"count":0,"href":"http:\/\/zydq.1006ss.com\/index.php?rest_route=\/wp\/v2\/posts\/29694\/revisions"}],"wp:attachment":[{"href":"http:\/\/zydq.1006ss.com\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=29694"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"http:\/\/zydq.1006ss.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=29694"},{"taxonomy":"post_tag","embeddable":true,"href":"http:\/\/zydq.1006ss.com\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=29694"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}