神经外科患者的手术内低血压和术后妄想之间的关联:一项回顾性队列研究
Qianyu Cui1, Muhan Li1, Jie Wang1
1Department of Anesthesiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, People's Republic of China.
Journal of neurosurgical anesthesiology
|January 22, 2026
概括
在脑瘤手术患者中,手术内低血压与术后妄想无关. 然而,瘤中线转移是神经外科手术后痴呆症的独立风险因素.
科学领域:
- 神经外科 神经外科
- 麻醉学 麻醉学
- 神经临界护理是指神经临界护理.
背景情况:
- 在脑瘤患者中,手术内低血压和术后妄想之间的关系还不清楚.
- 评估这种关联对于改善神经外科手术后患者的治疗结果至关重要.
研究的目的:
- 为了研究在接受为脑瘤切除的选择性骨切除术的成年患者中,手术内低血压和术后狂妄之间的关联.
主要方法:
- 对3项前性研究的二次分析,涉及738名因质瘤或前叶瘤切除而进行头骨切除的成年患者.
- 术内低血压的测量是使用曲线下的平均动脉压面积,时间加权的平均动脉压和累积的低血压持续时间.
- 主要结局是低血压指标和术后妄想之间的关联.
主要成果:
- 手术后妄发生在29.0%的患者中.
- 在手术内低血压 (MAP 60-75 mmHg,相对降低10%-40%) 和术后狂妄之间没有发现统计学上显著的关联.
- 手术前瘤中线转移是痴呆症的独立风险因素 (aOR 1.56) 并与时间加权的平均动脉压相互作用.
结论:
- 术内低血压与术后狂妄症没有显著的关联,在接受大脑瘤切除的选择性骨切除术的成年患者中.
- 瘤中线转移是这一患者群体中术后痴呆症的重要独立风险因素.
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