在脑瘤活检后的手术内血压和出血并发症:使用倾向性得分匹配分析的观察性研究
Narushi Sugii1, Masahide Matsuda1, Takao Tsurubuchi1
1Department of Neurosurgery, Institute of Medicine, University of Tsukuba.
Neurologia medico-chirurgica
|July 16, 2025
概括
在麻醉唤醒期间积极降低血压,在脑瘤活检后减少出血. 避免血压快速升高对于预防术后出血至关重要.
科学领域:
- 神经外科 神经外科
- 麻醉学 麻醉学
- 病理学 病理学 病理学
背景情况:
- 脑瘤活检对于诊断至关重要,但存在出血并发症的风险.
- 控制手术内血压,特别是在麻醉醒来期间,对于患者的治疗结果至关重要.
研究的目的:
- 为了评估手术内血压管理对脑瘤活检后出血并发症的影响.
- 为了评估在麻醉唤醒和术后出血期间血压变化之间的关联.
主要方法:
- 从2011年至2020年进行活检的122名患有恶性淋巴瘤或质瘤的患者的回顾性分析.
- 在麻醉醒来期间,轻度降血压政策 (2015年之前) 和激进政策 (2016年之后<140毫米) 之间的结果比较.
- 倾向性得分匹配和后勤回归分析以控制混因素.
主要成果:
- 积极的降血压政策显著降低了康复期间的最大血压 (165 mmHg与135 mmHg相比,p < 0.001).
- 随着侵略性政策的实施,整体出血率显著下降 (54.1%对31.1%,p=0.017).
- 在麻醉后醒来时血压急剧升高与症状性术后出血有显著联系 (p = 0.012).
结论:
- 在麻醉恢复期间采取积极的降血压策略,可以有效地减少脑瘤活检后的出血并发症.
- 控制血压水平和麻醉醒来期间的血压变化速度对于最小化术后出血风险至关重要.
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