颅内动脉狭窄支架成形术围手术期的优化管理

Effect of closed-loop optimal management mode based on quality feedback in perioperative period during stenting for intracranial artery stenosis

目的探讨基于质量反馈的闭环优化管理模式在颅内动脉狭窄患者支架成形术围手术期的作用。方法将114例拟行支架成形术的颅内动脉狭窄患者按随机数字表分组。对照组于围手术期予以常规管理,研究组于围手术期予以基于质量反馈的闭环优化管理。对比两组管理前、术前、管理后负性情绪,术中血压(BP)和心率(HR)变化量,术后3个月内再狭窄和并发症发生率。结果两组内部分别比较,管理后焦虑、抑郁评分<术前评分均<管理前评分(P<0.05),术前和管理后研究组评分均低于对照组(P<0.05);研究组术中BP和HR变化量均低于对照组(P<0.05);术后3个月内再狭窄和并发症发生率比较,研究组低于对照组(P<0.05)。结论对颅内动脉狭窄患者支架成形术围手术期应用基于质量反馈的闭环优化管理模式不仅能够减轻负性情绪,稳定术中BP和HR,还可减少术后再狭窄和并发症。

Objective To explore the effect of closed-loop optimal management mode based on quality feedback in the perioperative period of intracranial artery stenosis patients undergoing stenting. Methods A total of 114 patients with intracranial artery stenosis who were to undergo stenting were randomly divided into two groups according to random number table. The control group was given routine management in the perioperative period, while the study group was given closed-loop optimization management based on quality feedback in the perioperative period. The pre-and post-management and pre-operation negative emotions, changes in blood pressures(BP) and heart rates(HR), restenosis and complications within three months were compared between the two groups. Results Comparison internally carried out in the two groups showed that post-management anxiety and depression scores were lower than the pre-operation levels, and the pre-operation levels were lower than the pre-management levels(P <0.05). The study group registered lower pre-operation and post-management levels than that of the control group(P < 0.05). The study group recorded lower variation in BP and HR than that of the control group(P < 0.05). In terms of the incidence of restenosis and complications within three months after operation, the study group is lower than the control group(P < 0.050). Conclusion The quality feedback based closed-loop optimization management model in the perioperative period of intracranial artery stenosis patients with stenting can reduce negative emotions, stabilize intraoperative BP and HR, and lower the incidence of postoperative restenosis and complications.