[1]白　鹏　李寒阳　李正迁　王　涛　郭向阳.颈动脉内膜斑块切除术中血压调控水平与术后不良事件的关系[J].中国临床神经外科杂志,2017,(04):216-218.[doi:10.13798/j.issn.1009-153X.2017.04.003]
　BAI Peng,LI Han-yang,LI Zheng-qian,et al.Relationship of intraoperative blood pressure control with postoperative adverse events in patients undergoing carotid endarterectomy[J].,2017,(04):216-218.[doi:10.13798/j.issn.1009-153X.2017.04.003]
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颈动脉内膜斑块切除术中血压调控水平与术后不良事件的 关系()
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《中国临床神经外科杂志》[ISSN:1009-153X/CN:42-1603/TN]

卷:
期数:
2017年04期
页码:
216-218
栏目:
论著
出版日期:
2017-04-25

文章信息/Info

Title:
Relationship of intraoperative blood pressure control with postoperative adverse events in patients undergoing carotid endarterectomy
文章编号:
1009-153X（2017）04-0216-03
作者:
白　鹏　李寒阳　李正迁　王　涛　郭向阳
100191 北京，北京大学第三医院麻醉科（白　鹏、李寒阳、李正迁、郭向阳），神经外科（王　涛）
Author(s):
BAI Peng1;  LI Han-yang1;  LI Zheng-qian1;  WANG Tao2;  GUO Xiang-yang1.
1. Department of Anesthesiology, Third Hospital, Peking University Beijing 100083, China;
2. Department of Neurosurgery, Third Hospital, Peking University, Beijing 100083, China
关键词:
颈动脉内膜斑块切除术; 血压调控; 不良事件
Keywords:
Carotid stenosis;  carotid endarterectomy;  Blood pressure management;  Adverse events;  Relationship
分类号:
R 651.1+2
DOI:
10.13798/j.issn.1009-153X.2017.04.003
文献标志码:
A
摘要:
目的 分析颈动脉内膜斑块切除术（CEA）中血压调控水平与术后严重不良事件的关系。方法 回顾性分析2014年6月至2016年6月在北京大学第三医院行254例CEA的临床资料。根据术中患侧颈动脉血流阻断期间血压变化率[（阻断后收缩压-术前收缩压）/术前收缩压×100%]分为A组（血压变化率0~20%；110例）和B组（血压变化率>20%；144例）。以术后脑梗死、脑出血、心肌梗死及新发心律失常等不良事件为观察指标，采用多因素Logistic回归分析检验术中血压调控与术后不良事件的关系。结果 除术前高血压病史外，两组年龄、性别比、体重指数、糖尿病病史、心脏病病史、术前神经症状、颈部血管狭窄程度、颈动脉血流阻断时间等均无统计学差异（P>0.05）。虽然两组术后不良事件发生率无统计学差异（P>0.05），但A组术后脑梗死发生率偏高，而B组术后心肌梗死发生率偏高。多因素Logistic回归分析显示，颈动脉血流阻断后血压变化率并非术后脑梗死、脑出血、心肌梗死及新发心律失常的独立影响因素（P>0.05）。结论 临床传统范围内的血压调控水平可能不是CEA后脑梗死、脑出血、心肌梗死及新发心律失常的危险因素；但仍需结合病人术前血压水平及血管情况，加强术中血压监测，实施个体化的血压调控。
Abstract:
Objective To analyze the relationship between blood pressure management and postoperative adverse events in the patients with carotid stenoses undergoing carotid endarterectomy (CEA). Methods The clinical data of 254 patients with carotid stenoses, who underwent CEA from June, 2014 to June, 2016 were analyzed retrospectively. According to the systolic pressure change rate during the temporary occlusion of the carotid arteries [(blood pressure after the occlusion-preoperative blood pressure)/preoperative blood pressure×100%], the patients were divided into groups A (n=110, 0~20%) and B (n=144, >20%). The postoperative adverse events including cerebral infarction, cerebral hemorrhage, myocardial infarction and new-onset arrhythmia were recorded. Results There were no significant differences in age, sex ratio, preoperative history of diabetes and heart disease, preoperative neurological symptoms, degree of cerebral vascular stenosis, and time of occlusion of carotid artery between both the groups (P>0.05). There were no significant differences in the incidence of postoperative cerebral infarction, cerebral hemorrhage, myocardial infarction and new-onset arrhythmia between both the groups (P>0.05). Multivariate Logistic regression analysis showed that the systolic pressure change rate during the temporary occlusion of the carotid arteries was not the independent risk factors of above mentioned postoperative adverse events. Conclusions The blood pressure during carotid artery occlusion in CEA may not be a independent risk factor for postopertive cerebral infarction, cerebral hemorrhage, myocardial infarction and new-onset arrhythmia when it is within the conventionally controlled range. Nevertheless, it is necessary to strengthen blood pressure monitoring to provide individual management on the basis of preoperative blood pressure and vascular conditions.

参考文献/References:

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备注/Memo

备注/Memo:
基金项目：北京市首都卫生发展科研基金（首发2011-4023-04）；北京市科委2016年度科技计划重大课题（D161100003816002）
通讯作者：郭向阳，E-mail：puthmazk@163.com 王　涛，E-mail：tony428@sina.com
更新日期/Last Update: 2017-04-25