[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与术后不良事件的关系[J].中国临床神经外科杂志,2017,(03):139-141.[doi:10.13798/j.issn.1009-153X.2017.03.004]
　BAI Peng,LI Han-yang,LI Zheng-qian,et al.Relationship of blood pressure control with postoperative adverse events in patients with carotid stenoses undergoing carotid endarterectomy[J].,2017,(03):139-141.[doi:10.13798/j.issn.1009-153X.2017.03.004]
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颈动脉内膜斑块切除术中血压调控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03期
页码:
139-141
栏目:
论著
出版日期:
2017-03-20

文章信息/Info

Title:
Relationship of blood pressure control with postoperative adverse events in patients with carotid stenoses undergoing carotid endarterectomy
文章编号:
1009-153X（2017）03-0139-03
作者:
白　鹏　李寒阳　李正迁　王　涛　郭向阳
作者单位：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 739.41; R 651.1+1
DOI:
10.13798/j.issn.1009-153X.2017.03.004
文献标志码:
A
摘要:
目的 探讨颈动脉内膜斑块切除术（CEA）中血压调控水平与术后不良事件的关系。方法 回顾性分析2014年6月至2016年6月254例CEA患者的临床资料。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 A组术后发生脑梗死4例、脑出血1例、心肌梗死1例、新发心律失常1例；B组术后发生脑梗死2例、脑出血2例、心肌梗死4例、新发心律失常1例。两组总体不良事件发生率无统计学差异（P>0.05）。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脑梗死、脑出血、心肌梗死及新发心率失常的危险因素（P>0.05），而年龄（OR=1.271，95% CI为1.038~1.555）是术后新发心律失常的危险因素（P=0.02）。结论 在常规血压调控范围内，CEA中颈动脉血流阻断期间血压控制与术后脑出血、脑梗死、心肌梗死及新发心律失常等不良事件无明显相关性；CEA中颈动脉血流阻断后最佳血压调控目标仍需进一步研究。
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 hypertension, 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 postoperative incidence of 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. Nevertheless, age (OR=1.271, 95% CI 1.038~1.555; P<0.05) was the independent risk factors of new-onset arrhythmia after CEA. Conclusions The blood pressure control during the temporary occlusion carotid arteries in CEA may not be related to cerebral infarction, cerebral hemorrhage, myocardial infarction and new-onset arrhythmia. But it is necessary to study further the optimal blood pressure control during temporary occlusion of the carotid artery in CEA.

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）；北京市科委招标课题（D161100003816002）
通讯作者：王　涛，E-mail：tony428@sina.com
更新日期/Last Update: 2017-03-25