@article{oai:opcnr.repo.nii.ac.jp:00000061,
 author = {宮城, 裕子 and Miyagi, Yuko and 宮城, 航一 and Miyagi, Koichi},
 issue = {4},
 journal = {沖縄県立看護大学紀要, Journal of Okinawa Prefectural College of Nursing},
 month = {Mar},
 note = {NICU看護に必要な病態生理、頭蓋内圧亢進、脳灌流圧、脳組織代謝、二次性脳損傷の原因としてのグルタミン酸・カルシウム説、脳内熱貯留現象、再灌流障害を解説し、これら病態に対するバルビツレート療法と低体温療法の作用機序について述べた。また、以上の事項に基礎をおいたNICU看護はどのように展開されるべきか検討した。バルビツレート療法と低体温療法は、その治療の特性から、「くも膜下出血後の脳血管攣縮による脳虚血に対するバルビツレート療法」と「重症頭部外傷の治療に応用される低体温療法」について、(1)治療前の患者評価、(2)低体温、バルビツレート療法時の注意、(3)ウイーニング中の注意、(4)低体温、バルビツレート療法の評価といった各段階で、看護上留意しなければならない事項を考察した。, Treatments in NICU are aimed at hastening recovery and avoiding secondary brain damage after cerebral ischemia and head injury. Barbiturate therapy or/and hypothermia are utilized in the management of cerebral ischemia or severe traumatic brain injury. The main aim of this review are (1) to provide a short update on the most recent advances in our knowledge of the secondary brain damage mechanism after brain ischemia and injury, (2) to clarify the points of nursing during the course of hypothermia or barbiturate therapy. Concerning the neuropathological process of secondary brain damage, we comment on the extracellular glutamate-mediated neuronal death, cerebral thermo-pooling, reperfusion injury. And we also mentioned the cerebral protection mechanism of hypothermia and barbiturate therapy. As to the barbiturate therapy, we mentioned the prophylactic use of barbiturate against cerebral hypoxia from cerebral arterial vasospasm due to ruptured aneurysm. About hypothermia, we referred to this therapy for the severe head injury. In conclusions, we emphasized the importance of nursing care to avoid complications which are possible to occur in hypothermia and barbiturate therapy.},
 pages = {4--14},
 title = {NICUの看護:重症脳障害の病態生理とバルビツレート療法、低体温療法の看護},
 year = {2003},
 yomi = {ミヤギ, ユウコ and ミヤギ, コウイチ}
}