瘤切除的头骨切除术后的术后血压目标:一项全国调查
Patrick D Kelly1, Fatima Gauhar1, KiChang Kang2
1Department of Neurosurgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
Neurosurgery
|November 26, 2024
概括
大多数神经外科程序在骨切除瘤后设定了缩血压目标,在向<140毫米升和<160毫米升之间几乎是平等的划分.
科学领域:
- 神经外科 神经外科
- 麻醉学 麻醉学
- 关键护理医学 关键护理医学
背景情况:
- 切除术后的高血压会影响到90%的瘤切除患者.
- 术后高血压是术后内出血的疑似危险因素,是发病率和死亡率的主要原因.
- 由于缺乏基于证据的指导方针,手术后血压 (BP) 管理的当前做法因骨切割而有很大差异.
研究的目的:
- 在学术神经外科项目中调查术后血压管理的当前做法.
- 为了确定常见的血压目标和用于骨切割后用于瘤切除的药理干预措施.
主要方法:
- 在117个认可的国家神经外科住院培训计划中,向神经外科住院医生分发了一项横截面调查.
- 一份10项问卷收集了手术后血压管理实践的数据.
- 45所机构的66名居民的回复在项目层面上进行了分析,保留了高级居民对多个参与者计划的回复.
主要成果:
- 系统性血压 (SBP) 是设定术后血压目标 (42个程序) 的最常见参数.
- 常见的SBP目标是<140 mm Hg (41%-43%) 或<160 mm Hg (36%-39%),维持到第一个术后早晨.
- 静脉内注射的尼卡迪平和拉贝塔醇是实现BP目标的最常用的药物.
结论:
- 大多数学术神经外科课程在瘤切除的头骨切除后建立了术后SBP目标.
- 针对SBP <140 mm Hg和SBP <160 mm Hg的计划之间几乎均的划分.
- 这种变化表明临床平衡,支持未来临床试验的必要性,以指导最佳BP目标.
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