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在非心脏外科手术中的手术内血压管理:基于当前证据的叙述性综述
Alexandre Joosten1, Michelle S Chew2, Emmanuel Futier3
1Department of Anesthesiology and Perioperative Medicine, UCLA Medical Center, Los Angeles, USA. ajoosten@mednet.ucla.edu.
Intensive care medicine
|February 17, 2026
概括
对于大多数手术患者来说,维持60-65mmHg的平均动脉压 (MAP) 似乎足够. 个性化血液动力学管理显示了未来外科手术期间护理的前景,超越了普遍的MAP目标.
科学领域:
- 麻醉学和外科手术期间的医学.
- 心血管生理学心血管生理学
- 关键护理医学 关键护理医学
背景情况:
- 术内血压管理至关重要,但最佳目标仍在争论中.
- 现有证据将低平均动脉压 (MAP) 与不良的术后结果联系起来.
研究的目的:
- 审查当前关于手术内低血压和MAP目标的证据.
- 探索在手术期间个性化血液动力学管理的策略.
主要方法:
- 对观察性研究和随机对照试验 (RCT) 的系统审查.
- 对共识陈述和血液动力学监测技术进步的分析.
- 专注于成人非心脏手术和外科手术期间的器官损伤预防.
主要成果:
- 观察数据显示,MAP 60-70 mmHg与术后并发症之间存在关联.
- 较大的RCT (13,000多名患者) 与常规护理 (MAP ≥65 mmHg) 相比,没有发现较高或个性化MAP目标的改善结果.
- 新出现的证据表明,异构的血液动力学内型可能解释了对统一目标的不同反应.
结论:
- 对于大多数非心脏手术患者来说,MAP ≥60-65 mmHg可能是充足的.
- 未来的进步需要机械内型化和精确引导的血液动力学策略.
- 仅仅通过普遍MAP目标升级,不太可能改善患者的治疗结果.
关键词:
麻醉 麻醉是一种麻醉.自主监管 自主监管封闭循环血管压缩器血液动力学监测 血液动力学监测在手术期间出现的低血压.平均动脉压的平均值.术后并发症 术后并发症预测分析是一种预测分析.外科手术 手术手术更多相关视频
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