合理实施颅内高压监测与管理

颅内压增高会导致脑灌注不足，严重情况下甚至发生脑疝，这会引起颅脑损伤后病情恶化。因此，侵入性颅内压监测是治疗严重颅脑创伤的必要手段，合理实施颅内压监测与管理至为重要。然而，支持颅内压监测和治疗的证据还很薄弱，关于颅内压监测的使用的相关信息并不充分。新近发表的国际多中心临床研究探讨了颅内压监测的适应症、病理性颅内压的阈值以及管理策略的异质性，无创颅内压估算法以及信息分析的创新方法正在被广泛研究。人工智能在颅内压的监测和管理中的应用也正在开发中。本文对该领域的最新进展进行回顾，并阐述未来研究所面临的挑战。

Increased intracranial pressure may lead to insufficient of cerebral perfusion, and in severe cases, even cerebral hernia, which can worsen the condition after traumatic brain injury（TBI）. Therefore, invasive intracranial pressure monitoring is a necessary means of treating sTBI, and reasonable implementation of intracranial pressure monitoring and management is crucial. However, the evidences supporting these practice are scarce, and the intracranial pressure monitoring information is not enough. Recently published international multicenter clinical studies have explored the indications for intracranial pressure monitoring, the threshold for pathological intracranial pressure, and the heterogeneity of management strategies. Innovative methods for non-invasive intracranial pressure estimation and information analysis are being extensively studied. The application of artificial intelligence in the monitoring and management of intracranial pressure is also being developed. This article reviews the latest developments in this field and elaborates on the challenges faced by future research.