Xu Shancai, Wu Pei, Shi Huaizhang, Ji Zhiyong, Dai Jiaxing
Department of Neurosurgery, First Affiliated Hospital of Harbin Medical University, No. 23 Youzheng Street, Nangang District, Harbin, 150001, Heilongjiang, China.
Cell Biochem Biophys. 2015 Apr;71(3):1537-42. doi: 10.1007/s12013-014-0377-7.
Hyperperfusion syndrome (HPS) is a rare but potentially devastating postoperative complication developing after endarterectomy and carotid stenting. Limited information is available about this complication. The aim of this study was to assess the incidence of HPS and risk factors leading to its development. We retrospectively reviewed 178 consecutive cases of patients who underwent stenting of intracranial artery revascularization. We analyzed the association between HPS and patient's age, collateral vascular supply of the lesion, the interval between operation and the last occurrence of ischemic symptom, adequacy of blood pressure control after the operation, and other risk factors such as diabetes, smoking, hypertension, and gender. Of 178 included patients, we found HPS in six cases (3.4%). Failure to strictly control postoperative blood pressure, a less than 3-week long interval between operation and the last occurrence of ischemic symptom, and poor collateral circulation were significantly associated with the development of HPS. The aforementioned factors are predictors for HPS. We argue that nitroprusside should not be used to control blood pressure after the operation because its use permits considerable blood pressure fluctuations.
高灌注综合征（HPS）是一种罕见但可能具有毁灭性的术后并发症，发生于动脉内膜切除术和颈动脉支架置入术后。关于这种并发症的信息有限。本研究的目的是评估HPS的发生率及其发生的危险因素。我们回顾性分析了178例连续接受颅内动脉血运重建支架置入术的患者。我们分析了HPS与患者年龄、病变的侧支血管供应、手术与最后一次缺血症状出现之间的间隔时间、术后血压控制的充分性以及其他危险因素（如糖尿病、吸烟、高血压和性别）之间的关联。在178例纳入研究的患者中，我们发现6例（3.4%）发生了HPS。术后未能严格控制血压、手术与最后一次缺血症状出现之间的间隔时间少于3周以及侧支循环不良与HPS的发生显著相关。上述因素是HPS的预测指标。我们认为术后不应使用硝普钠控制血压，因为其使用会导致血压大幅波动。
