Chowdhury Tumul, Wilkinson Marshall, Cappellani Ronald B
University of ManitobaWinnipeg, MB, Canada.
Front Neurosci. 2017 Aug 28;11:477. doi: 10.3389/fnins.2017.00477. eCollection 2017.
Hemodynamic perturbations can be anticipated in deep brain stimulation (DBS) surgery and may be attributed to multiple factors. Acute changes in hemodynamics may produce rare but severe complications such as intracranial bleeding, transient ischemic stroke and myocardium infarction. Therefore, this retrospective study attempts to determine the incidence of hemodynamic perturbances (rate) and related risk factors in patients undergoing DBS surgery. After institutional approval, all patients undergoing DBS surgery for the past 10 years were recruited for this study. Demographic characteristics, procedural characteristics and intraoperative hemodynamic changes were noted. Event rate was calculated and the effect of all the variables on hemodynamic perturbations was analyzed by regression model. Total hemodynamic adverse events during DBS surgery was 10.8 (0-42) and treated in 57% of cases. Among all the perioperative variables, the baseline blood pressure including systolic, diastolic, and mean arterial pressure was found to have highly significant effect on these intraoperative hemodynamic perturbations.
在深部脑刺激(DBS)手术中可预期血流动力学扰动,且可能归因于多种因素。血流动力学的急性变化可能会产生罕见但严重的并发症,如颅内出血、短暂性缺血性中风和心肌梗死。因此,这项回顾性研究试图确定接受DBS手术患者的血流动力学扰动发生率(比率)及相关危险因素。经机构批准后,招募了过去10年中所有接受DBS手术的患者进行本研究。记录人口统计学特征、手术特征和术中血流动力学变化。计算事件发生率,并通过回归模型分析所有变量对血流动力学扰动的影响。DBS手术期间总的血流动力学不良事件发生率为10.8(0 - 42),57%的病例得到了治疗。在所有围手术期变量中,发现包括收缩压、舒张压和平均动脉压在内的基线血压对这些术中血流动力学扰动有高度显著影响。