血压管理对颈动脉内膜剥脱术后并发症的影响
Effect of blood pressure management on complication of CEA
王军 1赵海运 1马百涛 2张乐 3陶晓坤1
作者信息
- 1. 郑州大学第一附属医院手术部,郑州 450052
- 2. 郑州大学第一附属医院腔内血管外科,郑州 450052
- 3. 郑州大学第一附属医院麻醉科,郑州 450052
- 折叠
摘要
目的 探究颈动脉内膜剥脱术(carotid endarterectomy,CEA)术后不同的血压控制水平对围术期并发症发生率的影响.方法 收集2019年5月至2023年5月郑州大学第一附属医院完成的368例行颈动脉内膜切除术患者的临床资料,包括一般资料、围术期血压水平、术后并发症情况等.所有手术均顺利完成,依据术后血压控制水平,把368例患者分为A、B两组,控制A组术后血压较术前降低10％左右,控制B组术后血压较术前降低20％左右.结果 B组患者术后脑过度灌注综合征(cerebral hyperperfusion syndrome,CHS)发生率较A组明显降低(P＜0.05),两组患者术后颈部血肿、脑梗、神经损伤等的发生率差异无统计学意义(P＞0.05).结论 CEA术后将血压控制在术前水平的80％是安全的,其对脑梗、脑出血、颈部血肿、神经损伤的发生无显著影响,但是可明显降低CEA术后CHS的发生.
Abstract
Objective To investigate the effect of different levels of blood pressure control after carotid endarterectomy(CEA)on perioperative complication.Methods The clinical data of 368 patients undergoing carotid endarterectomy completed in our hospital from May 2019 to May 2023 were collected,including general information,perioperative blood pressure level,and postoperative complications.All the surgeries were successfully completed,and according to the postoperative blood pressure control level,368 patients were divided into two groups:A and B.The postoperative blood pressure in group A was controlled to decrease by about 10％compared to preoperative levels,while in group B,the postoperative blood pressure was controlled to decrease by about 20％compared to preoperative levels.Results The in-cidence of postoperative cerebral hyperperfusion syndrome(CHS)in group B was significantly lower than that in group A(P＜0.05),and there was no significant difference in the incidence of postoperative cervical hematoma,cerebral in-farction,and nerve injury between the two groups(P＞0.05).Conclusion It is safe to control the blood pressure after CEA to 80％of the preoperative level,and it has no significant effect on the occurrence of cerebral infarction,cerebral hemorrhage,neck hematoma and nerve injury,but it can significantly reduce the occurrence of CHS after CEA.
关键词
颈动脉内膜剥脱术/颈动脉狭窄/血压/脑过度灌注综合征Key words
Carotid endarterectomy/Carotid artery stenosis/Blood pressure/Cerebral overperfusion syndrome引用本文复制引用
基金项目
河南省医学科技攻关联合共建项目(LHGJ20190205)
出版年
2024
NETL
NSTL
万方数据