成年人围手术期血压目标控制研究进展

围手术期低血压经常发生，是外科患者发生术后器官功能不全和死亡的重要促进因素。文章回顾近年来围手术期血压控制水平与器官损伤相关的文献研究，从而为围手术期血压管理目标提供参考以减少术后器官功能不全的发生。目前缺少围手术期血压控制目标的共识，血压控制目标是一个动态管理的过程，不应视为一个固定值。血压目标设定的最终目的是维持器...

Advance in perioperative blood pressure control targets for adult candidates

Intraoperative hypotension frequently occurs and is an essential trigger of postoperative organ dysfunction and surgical patients'mortality.This review was to investigate recent literature regarding to the level of perioperative blood pressure control and its relationship with organ injury after surgery.Guiding blood pressure manage-ment and ameliorating complications in surgical patients.There is a lack of uniform definition or guidelines regarding blood pressure targets to ensure patient safety.Learning the dynamic nature of blood pressure may give more insight into the mechanism for adverse events and provide optimal intraoperative targets.The goal of blood pressure targets titration is to maintain organ perfusion and optimize the microcirculation-which,therefore,benefits patients'prognosis and outcome.The available evidence suggests that targeting a mean arterial pressure(MAP)of above 65 mmHg(1 mmHg=0.133 kPa)in a surgical patient without preexisting risk factors is a reasonable threshold.In patients with comorbid conditions,blood pressure management should be individually tailored to an optimal level considering physiology and the clinical situation.Personalized blood pressure management according to individual physiology and particular clinical situation may reduce postoperative organ dysfunction in surgical patients.A magnitude of±20%-±10%fluctuation based on baseline blood pressure is an optimal blood pressure target for highrisk patients.A sensitive biomarker in reflecting optimal blood pressure target and organ ischemic injury threshold helps blood pressure management.