精准血压管理预防烟雾病患者围手术期脑过度灌注综合征的效果及对预后的影响  

Role of precise blood pressure management in preventing cerebral hyperperfusion syndrome in patients with moyamoya disease during perioperation period and its impact on prognosis

作　　者：杨炳男 史锡文[1] 迁荣军[2] YANG Bingnan;SHI Xiwen;QIAN Rongjun(Cerebrovascular Disease Area 1,Henan Provincial People′s Hospital,Zhengzhou 450003;Neurosurgery Ward 1,Henan Provincial People′s Hospital,Zhengzhou 450003)

机构地区：[1]河南省人民医院脑血管一病区,郑州450003 [2]河南省人民医院神经外科一病区,郑州450003

出　　处：《郑州大学学报(医学版)》2025年第1期114-118,共5页Journal of Zhengzhou University(Medical Sciences)

基　　金：河南医学科技攻关计划省部共建重点项目(SBGJ202102029)。

摘　　要：目的:探究精准血压管理预防烟雾病患者围手术期脑过度灌注综合征(CHS)的效果及对预后的影响。方法:选取2020年2月至2023年2月河南省人民医院收治、行全麻血运重建术治疗的烟雾病患者98例,按随机数字排秩法分为研究组与对照组,各49例。除常规护理外,对照组予以常规血压管理,研究组予以精准血压管理。比较两组CHS发生情况和术后恢复质量(QoR-40评分)。术后3个月复查,比较两组认知功能与神经功能、日常生活功能(Barthel指数)。结果:研究组CHS发生率低于对照组(8.2%vs 24.5%,P=0.029),QoR-40量表总分差值均低于对照组(P<0.05)。术后3个月,研究组神经功能优于对照组,WAIS-RC、RBANS-DM、RBANS-IM评分均高于对照组,两组Barthel指数均升高,研究组优于对照组(P<0.05)。结论:精准血压管理可降低烟雾病患者术后CHS发生率,提升术后康复质量,促进术后认知功能与神经功能恢复,提高患者日常生活能力。Aim:To explore the role of accurate blood pressure management in preventing cerebral hyperperfusion syndrome(CHS)in patients with moyamoya disease during perioperation period and its impact on prognosis.Methods:Ninety-eight patients with moyamoya who underwent general anesthesia cerebral blood circulation reconstruction in Henan Provincial People′s Hospital from February 2020 to February 2023 were selected and allocated into control group and research group according to the random number ranking method,with 49 in each group.In addition to routine nursing,the control group was given routine blood pressure management,and the research group was given precise blood pressure management.The 2 groups were compared in terms of the occurrence of CHS,and the quality of postoperative recovery(QoR-40 score);and the differences in cognitive and neurological function,and function of daily life(Barthel index)at 3 months postoperatively were compared.Results:The incidence of CHS was lower in the research group than that in control group(8.2%vs 24.5%,P=0.029),and the difference in total score of the QoR-40 scale before and after blood pressure management was lower than that in control group.At 3 months postoperatively,compared with control group,the neurological function of the research group was better,and the WAIS-RC,RBANS-DM and RBANS-IM scores were higher(P<0.05);Barthel index was elevated in both groups,and the improvements in the research group was higher than that in control group(P<0.05).Conclusion:Precise blood pressure management could reduce the incidence of CHS after cerebral blood circulation reconstruction in patients with moyamoya,improve the quality of postoperative rehabilitation,promote the recovery of postoperative cognitive function and neurological function,and improve the ability of daily living.

关 键 词：烟雾病 精准血压管理 脑过度灌注综合征 预后 

分 类 号：R743.4[医药卫生—神经病学与精神病学]