ISSN 2097-6046（网络）
ISSN 2096-7446（印刷）
CN 10-1655/R
主管：中国科学技术协会
主办：中华护理学会
中华急危重症护理杂志

中华急危重症护理杂志 ›› 2026, Vol. 7 ›› Issue (9): 1029-1035.doi: 10.3761/j.issn.2096-7446.2026.09.001

• 论著 •    下一篇

烟雾病患者血管重建术后血压动态变化及对并发症的影响

顾秋萍1(), 章伟伟2, 徐高威3, 汪婧怡3, 唐小岚1, 袁媛3,*()   

  1. 1 浙江大学医学院附属第二医院康复科 杭州市 310009
    2 浙江大学医学院附属第二医院胸外科 杭州市 310009
    3 浙江大学医学院附属第二医院神经外科 杭州市 310009
  • 收稿日期:2026-02-11 出版日期:2026-09-10 发布日期:2026-08-31
  • 通讯作者: *袁媛，E-mail：2507163@zju.edu.cn
  • 作者简介:顾秋萍：女，硕士，主管护师，护士长，E-mail：guqiuping813@zju.edu.cn
    作者贡献声明

    顾秋萍：试验设计、论文撰写；章伟伟、徐高威、汪婧怡：数据收集及整理；唐小岚：统计学分析、论文修改；袁媛：研究设计与指导

  • 基金资助:
    浙江省医药卫生科技项目(2023KY750)

Dynamic blood pressure changes and their association with postoperative complications after revascularization surgery for moyamoya disease

GU Qiuping1(), ZHANG Weiwei2, XU Gaowei3, WANG Jingyi3, TANG Xiaolan1, YUAN Yuan3,*()   

  1. 1 Rehabilitation Department， the Second Affiliated Hospital of Zhejiang University School of Medicine， Hangzhou 310009， China
    2 Department of Thoracic Surgery， the Second Affiliated Hospital of Zhejiang University School of Medicine， Hangzhou 310009， China
    3 Department of Neurosurgery， the Second Affiliated Hospital of Zhejiang University School of Medicine， Hangzhou 310009， China
  • Received:2026-02-11 Online:2026-09-10 Published:2026-08-31
  • Contact: * YUAN Yuan，E-mail：2507163@zju.edu.cn
  • Supported by:
    Zhejiang Province Medical and Health Science and Technology Project(2023KY750)

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摘要：

目的 分析烟雾病患者血管重建术后72 h内血压动态变化及昼夜节律特征与术后并发症的相关性，为术后血压精细化管理提供依据。方法 回顾性分析2020年1月—2024年1月在浙江省某三级甲等医院行血管重建的401例烟雾病患者的临床资料，包括患者一般资料及术后72 h内每小时收缩压和舒张压数据。计算术后0~24 h、25~48 h、49~72 h不同时段血压变化的相关指标，并根据连续3 d夜间血压下降率的变化趋势，将收缩压节律变化模式分为波动、恶化和持续恶化3级。以术后7 d内是否发生并发症为因变量，采用多因素Logistic回归分析术后血压动态指标与并发症风险的关系。结果 烟雾病术后并发症发生率为26.93%（108/401）。多因素Logistic回归分析显示：收缩压昼夜节律恶化（aOR=1.366，95%CI：1.025~1.821，P=0.033）、术后0~48 h收缩压均值升高（aOR=1.611，95%CI：1.245~2.085，P<0.001）是术后并发症的独立危险因素。术后收缩压均值（123.4 mmHg，1 mmHg=0.133 kPa）每升高1个标准差（11.1 mmHg），并发症风险增加61.1%。结论 烟雾病术后0~48 h为关键时间窗，临床需实施精准血压管理，警惕昼夜节律动态恶化。

关键词: 烟雾病, 术后并发症, 血压监测, 昼夜节律, 血压变异性, 收缩压

Abstract:

Objective To analyze the association of dynamic blood pressure changes and circadian rhythm characteristics within 72 hours after revascularization surgery with postoperative complications in patients with moyamoya disease，and to provide a basis for the precise management of postoperative blood pressure. Methods Clinical data of 401 patients with moyamoya disease who underwent revascularization surgery at a tertiary Grade A hospital in Zhejiang Province from January 2020 to January 2024 were retrospectively analyzed. The collected data included general patient information and hourly systolic and diastolic blood pressure measurements within 72 hours after surgery. Blood pressure parameters were calculated for three postoperative time intervals：0-24 h，25-48 h，and 49-72 h. Based on the change trend of the nocturnal blood pressure decline rate over three consecutive days，the circadian rhythm patterns of systolic blood pressure were classified into three levels：fluctuation，deterioration pattern，and persistent deterioration. Multivariable logistic regression was performed to examine the association between blood pressure variability indicators and postoperative complications within 7 days after surgery. Results The incidence of postoperative complications was 26.93%（108/401）. Multivariable logistic regression analysis showed that deterioration of systolic circadian rhythm（aOR=1.366，95%CI：1.025-1.821，P=0.033） and elevated mean systolic blood pressure within 0~48 hours after surgery（aOR=1.611，95%CI：1.245-2.085，P<0.001） were independent risk factors for postoperative complications. Each one-standard-deviation increase of 11.1 mmHg in mean systolic blood pressure（123.4 mmHg，1 mmHg=0.133 kPa） was associated with a 61.1% increase in the risk of complications. Conclusion The first 48 hours following revascularization surgery for moyamoya disease represent a pivotal time window. During this period，stringent blood pressure control should be exercised，and clinicians should be alert to potential dynamic deterioration of the circadian rhythm.

Key words: Moyamoya Disease, Postoperative Complications, Blood Pressure Monitoring, Circadian Rhythm, Blood Pressure Variability, Systolic Blood Pressure