急性缺血性脑卒中患者机械取栓术后血压管理的最佳证据总结

doi:10.3761/j.issn.2096-7446.2025.03.019

摘要/Abstract

摘要：

目的检索、评价并汇总急性缺血性脑卒中（acute ischemic stroke，AIS）患者机械取栓术后血压管理的最佳证据，为临床实践提供循证依据。方法计算机检索国内外数据库中关于AIS患者机械取栓术后血压管理的临床决策、指南、证据总结、系统评价、专家共识和Meta分析。检索时限为建库起至2024年4月。由2名接受过循证护理培训的研究人员对纳入的文献独立进行质量评价、证据提取和证据综合。结果最终纳入文献13篇，包括指南7篇、系统评价2篇、专家共识4篇。从病情评估、血压目标、干预措施、用药管理、非药物治疗、质量控制、延续管理7个维度归纳了26条证据。结论该研究总结了AIS患者机械取栓术后血压管理的最佳证据，医护人员应结合患者实际情况个性化应用，规范术后血压管理行为，从而改善患者临床结局。

关键词: 急性缺血性脑卒中, 机械取栓, 血压管理, 证据总结, 循证护理学

Abstract:

Objective To retrieve，evaluate and summarize the evidence for management of blood pressure after mechanical embolectomy in patients with acute ischemic stroke，and provide evidence-based basis for clinical practice. Methods Clinical decisions，guidelines，evidence summaries，systematic reviews，expert consensus and meta-analyses on blood pressure management after mechanical thrombectomy in patients with acute ischemic stroke were searched by computer from domestic and foreign databases. The search period was from the establishment of the database to April 2024. Two researchers trained in evidence-based nursing independently performed quality assessment，evidence extraction and evidence synthesis on the included literature. Results A total of 13 articles were selected，including 7 guidelines，2 systematic reviews，and 4 expert consensus articles. Finally，26 pieces of evidence were summarized from 7 dimensions：disease assessment，blood pressure target，intervention measures，medication management，non-pharmacological treatment，quality control and continuous management. Conclusion This study summarized the best evidence of blood pressure management after mechanical embolectomy in patients with acute ischemic stroke. Medical staff should apply the evidence in a personalized way according to the actual situation of patients，standardize the postoperative blood pressure management behavior and ultimately improve the clinical outcome of patients.

Key words: Acute Ischemic Stroke, Mechanical Thrombectomy, Blood Pressure Management, Evidence Summary, Evidence-Based Nursing

祝晓娟, 虞杨, 王聪, 尹君莲, 镇雨珊, 王德生, 柏慧华. 急性缺血性脑卒中患者机械取栓术后血压管理的最佳证据总结[J]. 中华急危重症护理杂志, 2025, 6(3): 365-371.

ZHU Xiaojuan, YU Yang, WANG Cong, YIN Junlian, ZHEN Yushan, WANG Desheng, BAI Huihua. Summary of best evidence for management of blood pressure after mechanical embolectomy in patients with acute ischemic stroke[J]. Chinese Journal of Emergency and Critical Care Nursing, 2025, 6(3): 365-371.

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