控制性低血压对经过鼻腔手术后的术后认知结果的影响
Murat Kaykac1,2, Selcuk Kayir, Guvenc Dogan
1Department of Anaesthesiology and Reanimation, Izmir City Hospital, Izmir, Turkiye.
Journal of the College of Physicians and Surgeons--Pakistan : JCPSP
|September 15, 2025
概括
在鼻整形或血清整形期间将平均动脉压 (MAP) 降低到50-57mmHg,会增加早期术后妄想风险. 然而,这种控制的低血压策略不会对中长期的认知功能产生负面影响.
科学领域:
- 麻醉学 麻醉学
- 神经科学是一个神经科学.
- 手术科学 手术科学
背景情况:
- 控制性低血压在手术期间使用,以减少血液损失和改善可视化.
- 不同水平的控制性低血压对大脑氧化和术后认知结果的影响需要进一步研究.
- 鼻整形和隔膜整形是常见的手术,可以使用可控的低血压.
研究的目的:
- 评估两种受控的低血压策略在鼻整形和血清整形期间对大脑氧化的影响.
- 确定这些低血压水平与术后妄想和认知功能障碍的发生率之间的关联.
主要方法:
- 一项随机,双盲研究,涉及70名接受鼻整形或鼻腔整形的患者.
- 患者被分配接受麻醉,目标是50-57 mmHg (A组) 或58-65 mmHg (B组) 的平均动脉压 (MAP).
- 使用迷你心理测试 (MMT) 和迷你心理评分尺度-修订-98 (DRS-R-98) 评估认知功能和妄想.
主要成果:
- 在康复单位 (p <0.05) 观察到A组 (31.4%) 与B组 (5.7%) 相比,狂妄症的发生率显著更高.
- 组A在康复期间和手术后24小时也显示出更高的DRS-R-98分数.
- 在手术后24小时,7天或3个月后的组之间没有发现MMT得分的显著差异.
结论:
- 控制的低血压以50-57mmHg的MAP水平为目标,与早期术后狂妄症的风险增加有关.
- 这种低血压策略在中长期认知结果方面似乎是安全的.
- 密切的神经监测是关键的在立即康复期间的患者管理较低的MAP目标.
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