神经重症多模态脑监测

Multimodal Brain Monitoring in Neurocritical Care

摘要: 神经重症患者常面临急性脑损伤、颅内压升高及脑血流障碍等复杂病理生理问题，这些问题需要精准的监测手段以支持诊断和干预。传统神经监测方法以临床检查为主，但发现的变化往往是晚期体征，不足以发现和预防继发性脑损伤。近年来，多模态脑监测(MMM)技术的发展为神经重症监测提供了新的可能。MMM涵盖脑组织氧监测、脑血流监测、颅内压监测、脑电监测及脑代谢监测等多种手段，从多维度动态评估脑功能和病理状态。本文详细探讨了上述监测方法的原理、技术特点、临床应用及其在神经重症管理中的优势与局限性。没有一种单一的监测手段是适合所有患者，MMM是当前的趋势。随着该技术的进一步推广和应用，可为神经重症患者提供更为及时和个性化的治疗。

Abstract: Patients with severe neurological diseases in the neuroscience intensive care unit often face complex pathophysiological problems such as acute brain injury, increased intracranial pressure, and cerebral blood flow obstruction, which require precise monitoring techniques to support diagnosis and intervention. Traditional neurological monitoring methods are mainly based on clinical examination, but changes found during the examination are often late signs and insufficient to detect and prevent secondary brain injury. In recent years, the development of multimodal brain monitoring (MMM) technology has provided new possibilities for neurocritical care monitoring. MMM covers oxygen monitoring of brain tissue, cerebral blood flow monitoring, intracranial pressure monitoring, electroencephalography (EEG) monitoring, and cerebral metabolism monitoring, which evaluate brain function and pathological states from multiple dimensions and in a dynamic manner. This article discusses the principles, technical features, clinical applications, and advantages and limitations of the monitoring methods in detail. No single monitoring method is suitable for all patients, and MMM is the current trend. With the further promotion and application of this technology, it can provide more timely and personalized treatment for neurosurgical intensive care patients.