Joint arthroplasty Perioperative Surgical Home:Impact of patient characteristics on postoperative outcomes

AIM:To determine the impact of different characteristics on postoperative outcomes for patients in a joint arthroplasty Perioperative Surgical Home(PSH) program.METHODS:A retrospective review was performed for patients enrolled in a joint arthroplasty PSH program who had undergone primary total hip arthroplasty(THA) and total knee arthroplasty(TKA).Patients were preoperatively stratified based on specific procedure performed,age,gender,body mass index(BMI),American Society of Anesthesiologists Physical Classification System(ASA) score,and Charleston Comorbidity Index(CCI) score.The primary outcome criterion was hospital length of stay(LOS).Secondary criteria including operative room(OR) duration,trans-fusion rate,Post-Anesthesia Care Unit(PACU) stay,readmission rate,post-operative complications,and discharge disposition.For each outcome,the predictor variables were entered into a generalized linear model with appropriate response and assessed for predictive relationship to the dependent variable.Significance level was set to 0.05.RESULTS:A total of 337 patients,200 in the TKA cohort and 137 in the THA cohort,were eligible for the study.Nearly two-third of patients were female.Patient age averaged 64 years and preoperative BMI averaged 29 kg/m2.The majority of patients were ASA score Ⅲ and CCI score 0.After analysis,ASA score was the only variable predictive for LOS(P = 0.0011) and each increase in ASA score above 2 increased LOS by approximately 0.5 d.ASA score was also the only variable predictive for readmission rate(P = 0.0332).BMI was the only variable predictive for PACU duration(P = 0.0136).Specific procedure performed,age,gender,and CCI score were not predictive for any of the outcome criteria.OR duration,transfusion rate,postoperative complications or discharge disposition were not significantly associated with any of the predictor variables.CONCLUSION:The joint arthroplasty PSH model reduces postoperative outcome variability for patients with different preoperative characteristics and medical comorbidities.

Clinical Application and Research Progress of Accelerated Rehabilitation Surgery in Perioperative Period of Advanced Gastric Cancer in the Elderly

Enhanced recovery after surgery (ERAS) has been used in various surgical professions in recent years and is widely accepted by doctors. This concept not only helps patients speed up postoperative recovery, reduce the incidence of related complications and shorten hospital stays, but also has been proved to be effective and safe in the perioperative application of gastric cancer. This article reviews the clinical application and research progress of enhanced recovery after surgery in the perioperative period of advanced gastric cancer in the elderly.

Impact of the Rapid Recovery Concept on Complications and Patient Quality of Life in the Perioperative Nursing of Robot-Assisted Radical Oesophageal Cancer

Aim: This study evaluates the impact of Enhanced Recovery After Surgery (ERAS) nursing on postoperative complications and quality of life in patients undergoing robot-assisted minimally invasive esophagectomy (RAMIE). Methods: A total of 150 patients who underwent RAMIE from January 2020 to January 2022 at our hospital were randomly assigned to either the observation group or the control group, with 75 patients in each. The control group received standard perioperative management and nursing care, while the observation group was treated with ERAS nursing strategies. Interventions continued until discharge, and outcomes such as postoperative complications, quality of life, and nutritional status were compared between the groups. Results: The observation group exhibited a significantly lower incidence of postoperative adverse reactions compared to the control group (P ionally, all dimension scores of the Short-Form 36 Health Survey (SF-36), including the total score, were higher in the observation group (P < 0.05). Furthermore, the Nutritional Risk Screening (NRS) scores for impaired nutritional status and disease severity, along with the total NRS score, were significantly lower in the observation group compared to the control group (P Conclusion: Implementing ERAS nursing in the perioperative care of patients undergoing RAMIE is associated with reduced postoperative complications and enhanced postoperative quality of life and nutritional status. .

Practice of Perioperative Rational Use of Antibacterial Drugs Based on Drug Pathway

[Objectives]To establish a new management model for rational use of perioperative antibacterial drugs in surgical departments.[Methods]Based on evidence-based medicine,the department s drug pathway was formulated,and the new mode of rational drug use control was established by using fine pharmaceutical technology intervention,and the intervention effect was evaluated by the intensity of antibacterial drug use,per capita drug costs and the proportion of drugs.[Results]After adopting drug pathway in departments,the intensity of antibacterial drug use,per capita drug costs and the proportion of drugs decreased significantly,and the effect of rational drug use control was remarkable.[Conclusions]The drug pathway provides a new management and control mode for the rational use of perioperative antibacterial drugs in surgical departments of hospitals.Thus,it is worthy of popularization and application.

Efficacy and safety of perioperative therapy for locally resectable gastric cancer:A network meta-analysis of randomized clinical trials

BACKGROUND Gastric cancer(GC)is the fifth most commonly diagnosed malignancy worldwide,with over 1 million new cases per year,and the third leading cause of cancer-related death.AIM To determine the optimal perioperative treatment regimen for patients with locally resectable GC.METHODS A comprehensive literature search was conducted,focusing on phase II/III randomized controlled trials(RCTs)assessing perioperative chemotherapy and chemoradiotherapy in treating locally resectable GC.The R0 resection rate,overall survival(OS),disease-free survival(DFS),and incidence of grade 3 or higher nonsurgical severe adverse events(SAEs)associated with various perioperative regimens were analyzed.A Bayesian network meta-analysis was performed to compare treatment regimens and rank their efficacy.RESULTS Thirty RCTs involving 8346 patients were included in this study.Neoadjuvant XELOX plus neoadjuvant radiotherapy and neoadjuvant CF were found to significantly improve the R0 resection rate compared with surgery alone,and the former had the highest probability of being the most effective option in this context.Neoadjuvant plus adjuvant FLOT was associated with the highest probability of being the best regimen for improving OS.Owing to limited data,no definitive ranking could be determined for DFS.Considering nonsurgical SAEs,FLO has emerged as the safest treatment regimen.CONCLUSION This study provides valuable insights for clinicians when selecting perioperative treatment regimens for patients with locally resectable GC.Further studies are required to validate these findings.

Correlation of angiotensin converting enzyme gene polymorphism with perioperative myocardial protection under extracorporeal circulation

Objective:To observe the expression of angiotensin converting enzyme(ACE),angiotensinⅡ(AngⅡ),cardiac troponin 【cTnⅠ),creatine kinase isozymes(CK-MB) and muscle red protein(Myo) after cardiopulmonary bypass(CPB),and to investigate the association of polymorphisms in angiotensin converting enzyme genes and myocardial injury.Methods:Sixty-three patients suffered from rheumatic mitral stenosis and scheduled for mitral valve replacement with CPB, were randomly divided into three groups according polymorphisms in angiotensin converting enzyme genes:typeⅡ,type ID,type DD(each=21).Blood samples were withdrawn from artery before operation(T1),at the beginning of CPB(T2),30 min after CPB(T3),(T4) at the end of CPB(T5), 2 h after CPB(T6),6 h after CPB(17) to measure the expression of ACE,AngⅡ,cTnⅠ,CK-MB, Myo.Results:The level of ACE during and after CPB were significantly higher than those before CPB(P【0.05).As extension of CPB time,the expression of ACE was increased.The level of cTnⅠ, CK-MB,Myo after CPB were significantly higher than those before CPB(P【0.05).The level of cTnⅠ,CK-MB and Myo were highest at T7,T6 and T5 and T7,respectively.The level of ACE,AngⅡ,cTnⅠin patients with DD genotype was significantly higher than the ID andⅡgenotype(P【 0.05).Besides,the level of ACE,AngⅡin patients with ID genotype was significantly higher than the II(P【 0.05).Conclusions:There is certain correlation between CPB perioperative midterm ACE and cTnⅠ,Myo,CK-MB.ACE DD genotype is a susceptibility gene of the CPB perioperative myocardial injury.

Analysis of the Effect of Comfort Care in The Perioperative Care of Patients with Hysteromyomectomy and its Influence on Self-Care Ability

Objective:To analyze the effect of perioperative comfort care for patients with hysteromyomectomy(HYS).Methods:Seventy cases of HYS patients admitted to our hospital from October 2022 to October 2023 were randomly selected and divided into Group A(control group,35 cases,conventional care)and Group B(observation group 35 cases,comfort care).The effects of the two groups before and after nursing care were compared.Results:The self-rating anxiety(SAS)scores,exercise of self-care agency(ESCA)scores,and nursing satisfaction scores at the time of discharge of Group B were better than in Group A after nursing care(P<0.05).Conclusion:Perioperative comfort care for HYS patients improved the patient’s adverse emotions,self-care ability,and nursing satisfaction.

The Impact of Patient Education on the Nursing Care of Perioperative Patients in the Interventional Catheterization Room

Objective:To explore and analyze the effect of implementing a precise education model on the nursing care of perioperative patients in the interventional catheterization room.Methods:We selected 70 patients who were going to undergo surgical intervention in our hospital from August 2020 to December 2022 as the subjects for this study through random sampling.The patients were divided into a control group and an observation group,with 35 cases in each group.The control group underwent basic nursing intervention,and the observation group was given precise patient education.The nursing effects of both groups were observed.Results:After the intervention,all compliance indicators of the observation group were better than those of the control group(P<0.05).Besides,the incidence of complications in the observation group(2.86%)was lower than that of the control group(17.14%)with P<0.05.Furthermore,the patient satisfaction of the observation group(97.14%)was higher than that of the control group(82.86%),with P<0.05.Conclusion:A precise propaganda and education model facilitates the nursing of perioperative patients in the interventional catheterization room.Therefore,this practice should be popularized.

Analysis of the Effect of Intensive Nursing Care on Improving Sleep Quality During the Perioperative Period of Severed Finger Reimplantation

Objective:To investigate the clinical effect of perioperative intensive nursing on patients who underwent severed finger reimplantation and its influence on sleep quality.Methods:62 patients who underwent severed finger reimplantation between January 2023 and December 2023 were included.They were divided into two groups:the observation group(n=31)and the control group(n=31).The control group received basic nursing interventions,while the observation group received intensive nursing care.The comparison parameters included visual analog pain score(VAS),incidence of vascular crises,length of hospitalization,Pittsburgh Sleep Quality Index(PSQI),Hamilton Depression Score(HAM-D),Hamilton Anxiety Score(HAM-A),and patient satisfaction.Results:Postoperative VAS score,incidence of vascular crisis,hospitalization time,PSQI score,and HAM-A and HAM-D scores of the observation group were lower than those of the control group(P<0.05).Meanwhile,the patient satisfaction of the observation group was higher than that of the control group(P<0.05).Conclusion:Perioperative intensive nursing care for patients undergoing severed finger reimplantation demonstrates significant benefits.It reduces postoperative pain,lowers the incidence of vascular crises,shortens hospitalization durations,enhances sleep quality,alleviates negative emotions,and improves nursing satisfaction.These findings underscore the importance and applicability of such care practices.

Modulation of splanchnic circulation:Role in perioperativemanagement of liver transplant patients

Splanchnic circulation is the primary mechanism thatregulates volumes of circulating blood and systemic blood pressure in patients with cirrhosis accompanied by portal hypertension. Recently, interest has been expressed in modulating splanchnic circulation in patients with liver cirrhosis, because this capability might produce beneficial effects in cirrhotic patients undergoing a liver transplant. Pharmacologic modulation of splanchnic circulation by use of vasoconstrictors might minimize venous congestion, replenish central blood flow, and thus optimize management of blood volume during a liver transplant operation. Moreover, splanchnic modulation minimizes any high portal blood flow that may occur following liver resection and the subsequent liver transplant. This effect is significant, because high portal flow impairs liver regeneration, and thus adversely affects the postoperative recovery of a transplant patient. An increase in portal blood flow can be minimized by either surgical methods(e.g., splenic artery ligation, splenectomy or portocaval shunting) or administration of splanchnic vasoconstrictor drugs such as Vasopressin or terlipressin. Finally, modulation of splanchnic circulation can help maintain perioperative renal function. Splanchnic vasoconstrictors such as terlipressin may help protect against acute kidney injury in patients undergoing liver transplantation by reducing portal pressure and the severity of a hyperdynamic state. These effects are especially important in patients who receive a too small for size graft. Terlipressin selectively stimulates V1 receptors, and thus causes arteriolar vasoconstriction in the splanchnic region, with a consequent shift of blood from splanchnic to systemic circulation. As a result, terlipressin enhances renal perfusion by increasing both effective blood volume and mean arterial pressure.

Impact of perioperative transfusion in patients undergoing resection of colorectal cancer liver metastases: A population-based study

BACKGROUND Perioperative allogeneic blood transfusion is associated with poorer outcomes.AIM To identify the factors that were associated with perioperative transfusion and to examine the impact of perioperative transfusion in patients undergoing resection of colorectal cancer(CRC)liver metastases.METHODS The United States National Inpatient Sample(NIS)database was searched for patients with CRC who received surgery for liver metastasis.Linear and logistic regression analyses were performed.RESULTS A total of 2018 patients were included,and 480 had a perioperative transfusion.Emergency admission(adjusted odds ratio[aOR]=1.42;95%CI:1.07-1.87),hepatic lobectomy(aOR=1.76;95%CI:1.42-2.19),and chronic anemia(aOR=2.62;95%CI:2.04-3.35)were associated with increased chances of receiving a transfusion,but receiving surgery at a teaching hospital(aOR=0.75;95%CI:0.58-0.98)was associated with a decreased chance of receiving a transfusion.Receiving a perioperative transfusion was significantly associated with increased in-hospital mortality(aOR=3.38;95%CI:1.57-7.25),and increased overall postoperative complications(aOR=1.67;95%CI:1.31-2.13),as well as longer length of hospital stay CONCLUSION Patients with an emergency admission,hepatic lobectomy,chronic anemia,and who have surgery at a non-teaching hospital are more likely to receive a perioperative transfusion.Patients with CRC undergoing surgery for hepatic metastases who receive a perioperative transfusion are at a higher risk of inhospital mortality,postoperative complications,and longer length of hospital stay.

Metabolic Syndrome and Perioperative Complications during Scheduled Surgeries with Spinal Anesthesia

Background: Metabolic syndrome (MS) is a constellation of factors associated with increased risk of developing cardiovascular diseases and Diabetes Mellitus. Despite of the many studies related to MS, little is known about its impact on scenarios such as surgical anesthesia. Objective: To examine the correlation between demographic and metabolic variables with the occurrence of perioperative complications in patients with MS undergoing scheduled surgeries using a spinal anesthesia technique in the surgery department at the University Clinic San Juan de Dios in Cartagena de Indias, Colombia. Methods: Observational, analytical, cross-sectional, single-center study of 150 subjects with MS and 150 control subjects. Perioperative complications, socio-demographic, hemodynamic and respiratory variables were registered. Groups were compared using t test, Fisher’s exact test or Chi-square, as appropriate. We applied a logistic multiple regression model, adjusted by backward stepwise at 0.25 and forward at 0.05, to find possible incompatible associations. p value < 0.05 was considered significant. Results: There were significant differences between groups in age, American Society of Anesthesiologists physical status classification, frequency of diseases associated to MS and perioperative complications. There were no cases of mortality among patients. There was statistically significant difference between the two groups for intraoperative hypotension and hypertension with p values of <0.0001 and 0.034. Among postoperative complications there was statistically significant difference in pain (13.3% vs 5.3% in patients without MS) and nausea and/or postoperative vomiting (8% vs 2% in patients without MS) with a p value of 0.027 and 0.015 (by Fisher) respectively. Conclusions: Metabolic abnormalities in MS are a risk factor for developing complications in the perioperative period of patients scheduled for surgeries using the subarachnoid anesthesia technique. Accordingly, it is appropriate to implement health intervention strategies by the surgical team, aiming at their prevention and management.

Cranial ultrasound in perioperative period of acute severe traumatic brain injury

Objective To observe the value of cranial ultrasound for perioperative patients with acute severe traumatic brain injury(sTBI).Methods Data of 55 sTBI patients who underwent craniotomy were retrospectively analyzed.The patients were divided into observation group(n=15)and control group(n=40)according to received perioperative cranial ultrasound or not.The general data and surgical data were compared between groups,and ultrasonic data of observation group were analyzed.Results The proportions of good prognosis 1 and 6 months after operation in observation group were both higher than those in control group,while the incidence of cerebral infarction in observation group was lower than that in control group(all P<0.05).No significant difference of general data nor other surgical data was found between groups(all P>0.05).Acute encephalocele occurred in 1 case in observation group during operation,and cranial ultrasound accurately showed the contralateral secondary epidural hematoma.Increased intracranial pressure in different degrees were found in all 15 cases(15/15,100%)in observation group after operation with transcranial color coded Doppler(TCCD)or transcranial Doppler(TCD),while cerebral vascular spasm was observed in 5 cases(5/15,33.33%),among them 4 cases(4/5,80.00%)were diagnosed cerebral infarction based on CT examination.Conclusion Cranial ultrasound could be used to evaluate changes of sTBI in perioperative period and guide adjusting treatment strategy in time,being valuable for reducing risk of postoperative cerebral infarction and improving prognosis.

Application of Clinical Care Pathway in Perioperative Patients with Autologous Arteriovenous Fistula Balloon Expansion

[Objective] To explore the effect of clinical care pathways in perioperative patients with autologous arteriovenous fistula balloon expansion. [Method] 202 patients undergoing autologous arteriovenous fistula from July 2021 to June 2022 were randomly divided into a control group (101 cases) and an observation group (101 cases) to compare the incidence rates of postoperative complications, hospitalization days, hospitalization expenses, knowledge of self-management of arteriovenous fistula and nursing satisfaction. [Results] In the observation group, the incidence of arteriovenous fistula was higher than that of the control group, and the hospitalization days and hospitalization costs were lower than that of the control group. The difference between the two groups was statistically significant (P < 0.05). [Conclusion] The application of the clinical nursing path to intervene in patients with autologous arteriovenous fistula balloon dilation can reduce the incidence of postoperative complications, shorten the hospital length of time, reduce hospitalization costs and improve patient satisfaction, which is clinical promotion significance.

Improvement of inflammatory response and gastrointestinal function in perioperative of cholelithiasis by Modified Xiao-Cheng-Qi decoction

BACKGROUND In the perioperative period of biliary surgery,various factors can induce the release of a large number of inflammatory factors,leading to an imbalance in proinflammatory and anti-inflammatory responses and resulting in gastrointestinal(GI)dysfunction.Enhanced Recovery After Surgery protocols in biliary surgery have been shown to reduce the stress response and accelerate postoperative recovery.It is crucial to reduce the inflammatory response and promote the recovery of GI function after biliary surgery,both of which are the basis and key for perioperative care and postoperative recovery.AIM To better understand the effects of Modified Xiao-Cheng-Qi decoction(MXD)on inflammatory response and GI function in the perioperative management of cholelithiasis and their correlation.METHODS This was a prospective randomized placebo-controlled trial,in which 162 patients who received biliary tract surgery were randomly assigned to three groups:MXD group,XD group,and placebo-control group.The observed parameters included frequency of bowel sounds,time of first flatus and defecation,time of diet,and amount of activity after surgery.The serum levels of C-reactive protein(CRP),interleukin(IL)-6,IL-10,serum amyloid A protein(SAA),and substance P were measured by the enzyme-linked immunosorbent assay.Then,the spearman correlation coefficient was used to analyze the relationship between the indicators of GI function and inflammation.RESULTS Compared to the placebo-control,improvements in GI function were observed in the MXD groups including reduced incidence of nausea,vomiting,and bloating;and earlier first exhaust time,first defecation time,and feeding time after surgery(P<0.05).On the 1st and 2nd d after surgery,IL-6,CRP and SAA levels in MXD group were lower than that in placebo control,but substance P level was higher,compared to the control(P<0.05).Functional diarrhea occurred in both MXD and XD groups without any other adverse effects,toxic reactions,and allergic reactions.Diarrhea was relieved after the discontinuation of the investigational remedies.Bowel sounds at 12 h after surgery,the occurring time of the first flatus,first defecation,postoperative liquid diet and semiliquid diet were significantly correlated with levels of IL-6,CRP,SAA and substance P on second day after surgery(P<0.05).CONCLUSION Treatment with MXD can relieve inflammatory response and improve GI function after surgery.Moreover,there are significant correlations between them.Furthermore,it does not cause serious adverse reactions.

Analysis of Perioperative Respiratory Care Methods and their Application Value in Children with Congenital Heart Disease

Objective:To analyze the perioperative respiratory care methods and application value in children with congenital heart disease.Methods:60 children with congenital heart disease(treated from January 2021 to October 2023)were screened and divided into two groups randomly.Each group consisted of 30 cases.The perioperative routine was used in the control group.The observation group underwent the perioperative routine along with better respiratory care.Oxygenation indicators,surgical complications,and family satisfaction levels of the groups were compared.Results:There was no significant difference in the oxygenation index between the two groups of children at admission(P>0.05).At discharge,the oxygenation indicators in the observation group were better than those of the control group,and the incidence of surgical complications was lower than that of the control group.The total satisfaction of family members in the observation group was higher than that of the control group(P<0.05).Conclusion:During the perioperative period for children with congenital heart disease,the implementation of respiratory care,which mainly involves symptomatic care,catheter care,sputum suction care,etc.,can actively improve the oxygenation indicators,reduce surgical complications,and promote faster and better recovery,of children with congenital heart disease.

Cirrhotic cardiomyopathy: Implications for the perioperative management of liver transplant patients

Cirrhotic cardiomyopathy is a disease that has only recently been recognised as a definitive clinical entity. In the setting of liver cirrhosis, it is characterized by a blunted inotropic and chronotropic response t o s t r e s s, i m p a i r e d d i a s t o l i c r e l a x a t i o n o f t h e myocardium and prolongation of the QT interval in the absence of other known cardiac disease. A key pathological feature is the persistent over-activation of the sympathetic nervous system in cirrhosis, which leads to down-regulation and dysfunction of theβ-adrenergic receptor. Diagnosis can be made using a combination of echocardiography(resting and stress), tissue Doppler imaging, cardiac magnetic resonance imaging, 12-lead electrocardiogram and measurement of biomarkers. There are significant implications of cirrhotic cardiomyopathy in a number of clinical situations in which there is an increased physiological demand, which can lead to acute cardiac decompensation and heart failure. Prior to transplantation there is an increased risk of hepatorenal syndrome, cardiac failure following transjugular intrahepatic portosystemic shunt insertion and increased risk of arrhythmias during acute gastrointestinal bleeding. Liver transplantation presents the greatest physiological challenge with a further risk of acute cardiac decompensation. Peri-operative management should involve appropriate choice of graft and minimization of large fluctuations in preload and afterload. The avoidance of cardiac failure during this period has important prognostic implications, as there is evidence to suggest a long-term resolution of the abnormalities in cirrhotic cardiomyopathy.

Relationship between perioperative anaemia and outcomes in older people with hip fractures: A systematic review and meta-analysis protocol

BACKGROUND Hip fractures are common with increasing age and is associated with decline in mobility. Both the fracture and the surgery can lead to blood loss, resulting in anaemia. However, it is uncertain at which time point haemoglobin is most strongly associated with different clinical outcomes after hip fracture. Our hypothesis is perioperative anaemia (admission, postoperative and discharge) during hip fracture surgery is associated with poor clinical outcomes. AIM To determine the effects of perioperative anaemia during hip fracture surgery on mortality, functional status and other clinical outcomes. METHODS Electronic databases will be searched to identify studies evaluating perioperative anaemia and outcomes of hip fracture surgery. Reference lists of included studies will also be searched to identify additional published studies. Eligibility criteria are as follows: Population: People who underwent hip fracture surgery;Exposure: Perioperative anaemia;Comparison: No anaemia before or after hip fracture surgery;Outcome: Mortality, hospital length of stay, postoperative complications, hospital readmission, change of discharge destination, quality of life and functional status. Risk of bias assessment will be assessed using the Cochrane Collaboration’s tool for randomized controlled trials and the modified version of the Epidemiological Appraisal Instrument for observational studies. Data will be pooled for meta-analysis if deemed appropriate. CONCLUSION This review seeks to clarify outcomes associated with perioperative anaemia at various time-points around hip fracture surgery. These findings will potentially inform evidence-based clinical practice on interventions in those with anaemia.

Current trends in perioperative treatment of resectable gastric cancer

In the last few decades,the treatment strategy for locally advanced resectable gastric cancer(GC)has shifted to a multimodal approach,which potentially decreases recurrence risk and improves survival rates.Perioperative therapy leads to downstaging,increased curative resection rates,and prolonged disease-free and overall survival,by preventing micrometastases in patients with resectable GC.Application of neoadjuvant therapy provides information about tumor biology and in vivo sensitivity.A consensus regarding the therapeutic approach for non-metastatic GC does not exist,and many clinical trials aim to clarify this aspect.Advances in precision medicine and the role of immunotherapy have been the focus of research in GC treatment.Herein,the current status and possible future developments of perioperative therapy for locally advanced resectable GC are reviewed,based on the most recent randomized clinical trials.

Management of Perioperative Target Blood Pressure in Bridging Therapy for Acute Ischemic Stroke

Objective:To investigate the management of perioperative target blood pressure in the treatment of acute ischemic stroke with intravenous thrombolytic bridging.Methods:Retrospective analysis of the blood pressure management and nursing experience of 36 patients with acute ischemic stroke who received endovascular treatment with bridge mode from November 2017 to January 2019 in our hospital.Through correct monitoring of basic blood pressure,rapid and stable blood pressure reduction before the bridge treatment,close cooperation during the operation,and close observation and treatment of postoperative blood pressure fluctuations,the patient’s blood pressure can be controlled within the target range.Results:The blood vessels of 36 patients were partially or completely recanalized after treatment.Clinical outcomes:Two cases died.After 90 days,29 patients with good clinical outcomes were followed up,and 5 patients with poor clinical prognosis.Conclusion:Effective blood pressure management is a necessary measure in the perioperative period of bridging therapy for patients with acute ischemic stroke,which can reduce the postoperative complications of patients treated with bridging therapy,obtain good therapeutic effect and improve the prognosis of patients.