避免低血压与避免高血压策略对非心脏手术后神经认知结果的影响
Maura Marcucci1, Matthew T V Chan2, Thomas W Painter3
1Population Health Research Institute, Hamilton, Ontario, Canada; Clinical Epidemiology and Research Centre, Humanitas University & IRCCS Humanitas Research Hospital, Milan, Italy; and Department of Health Research Methods, McMaster University, Hamilton, Ontario, Canada (M.Marcucci).
Annals of internal medicine
|June 2, 2025
概括
这项研究发现,在接受非心脏手术的高血管风险患者中,低血压避免和高血压避免策略之间的神经认知结果没有显著差异. 这两种策略都显示出类似的妄想率和1年的认知衰退.
科学领域:
- 麻醉学 麻醉学
- 神经科学是一个神经科学.
- 关键护理医学 关键护理医学
背景情况:
- 外科手术期间的血液动力学异常与非心脏手术后的神经认知结果有关.
- 在手术期间控制血压对于患者的康复至关重要.
- 了解最佳的血液动力学目标对于预防认知衰退至关重要.
研究的目的:
- 为了比较低血压避免与高血压避免策略的效果.
- 评估非心脏手术后对妄和1年认知衰退的影响.
- 为外科手术期间的血液动力学管理提供基于证据的建议.
主要方法:
- 随机对照试验在19个国家的54个中心进行.
- 包括2603名高血管风险患者服用抗高血压药物.
- 与手术内平均动脉压目标和药物管理策略进行比较.
主要成果:
- 避免低血压 (7.3%) 和避免高血压 (7.0%) 组之间妄率没有显著差异.
- 两种策略之间的1年认知衰退 (MoCA) 没有显著差异.
- 避免低血压的策略导致需要干预的手术内低血压较少.
结论:
- 避免低血压和避免高血压的策略都没有显示出神经认知结果的显著差异.
- 可能需要进一步的研究来优化特定患者群体的血液动力学管理.
- 这项研究为管理非心脏手术期间的血压提供了宝贵的见解.
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