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

doi:10.3761/j.issn.2096-7446.2026.09.001

Abstract

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

GU Qiuping, ZHANG Weiwei, XU Gaowei, WANG Jingyi, TANG Xiaolan, YUAN Yuan. Dynamic blood pressure changes and their association with postoperative complications after revascularization surgery for moyamoya disease[J]. Chinese Journal of Emergency and Critical Care Nursing, 2026, 7(9): 1029-1035.

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

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