顱內調適能力降低病人的臨床評估及護理處置

Clinical Evaluation and Nursing Management of a Patient With Decreased Intracranial Adaptive Capacity

王立葳(Li-Wei Wang) ； 高啟雯(Chi-Wen Kao)

《護理雜誌》 59卷5期 (2012/10) Pp. 91-96

https://doi.org/10.6224/JN.59.5.91

摘要

顱內調適能力降低為神經重症病人最常見的問題，也是導致顱內高壓的主因，若未經適當處理會影響病人的預後，甚至引起續發性腦損傷或死亡。本篇文章主要探討造成顱內調適能力降低的機轉及其影響，並針對相關因素提出臨床常見的評估方式及護理處置，期望能增進護理人員對顱內調適能力降低之成因有足夠的認知，且採取合宜的處置實際運用於臨床，達到病人最佳的治療效果及預後。

關鍵字

顱內調適能力 ； 顱內調適能力降低 ； 顱內高壓

並列摘要

Decreased intracranial adaptive capacity is one of the most common neurological problems in critically ill patients. It is the main cause of intracranial hypertension and, if not handled properly, is likely to negatively affect patient prognoses and may lead to further brain injury or death. This article describes concepts related to the mechanisms that cause decreased intracranial adaptive capacity and related factors. This article may provide a guide for clinical evaluation and nursing management. We hope to increase nursing staff knowledge to ensure they take the clinical management action necessary to prevent intracranial hypertension and provide optimal patient treatment and prognosis.

並列關鍵字

intracranial adaptive capacity ； decreased intracranial adaptive capacity ； intracranial hypertension

參考文獻

高明見（2008）．嚴重腦外傷的減壓顱骨切除術．台灣醫界，51（6），233－235。

Biousse, V., Rucker, J. C., Vignal, C., Crassard, I., Katz, B. J., & Newman, N. J. (2003). Anemia and papilledema. American Journal of Ophthalmology, 135(4), 437－446. doi:10.1016/S0002-9394(02)02062-7

Ennis, K., & Brophy, G. (2011). Management of intracranial hypertension: Focus on pharmacologic strategies. AACN Advanced Critical Care, 22(3), 177－182. doi:10.1097/NCI.0b013e318214564b

Josephson, L. (2004). Management of increased intracranial pressure: A primer for the non-neuro critical care nurse. Dimensions of Critical Care Nursing, 23(5), 194－207.

Kerr, M. E., Weber, B. B., Sereika, S. M., Wilberger, J., & Marion, D. W. (2001). Dose response to cerebrospinal fluid drainage on cerebral perfusion in traumatic brain-injured adults. Neuro­surgical Focus, 11(4), 1－7. doi:10.3137/foc.2001.11.4.2