Wang Shuhua, Xu Jiahao, Liang Jiexian, Qiu Qianhui, Ji Wenjin
Department of Anesthesiology, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China.
Department of Anesthesiology, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, Guangdong, China.
Med Sci Monit. 2025 Jun 8;31:e948124. doi: 10.12659/MSM.948124.
BACKGROUND Endoscopic surgery has become increasingly important in management of nasopharyngeal carcinoma (NPC). However, limited research exists on postoperative hypotension in NPC patients undergoing endoscopic surgery. This retrospective study aimed to analyze the risk factors associated with postoperative hypotension in such patients. MATERIAL AND METHODS This retrospective study included NPC patients who underwent endoscopic surgery after radiotherapy at Guangdong Provincial People's Hospital between 2021 and 2023. Patients with systolic blood pressure (SBP) <90 mmHg or mean arterial pressure (MAP) <65 mmHg were categorized into the hypotension group. Multiple logistic regression analysis was performed to identify the risk factors associated with postoperative hypotension. RESULTS Among 264 patients, 86 (32.5%) experienced postoperative hypotension. Univariate analysis revealed significant associations between postoperative hypotension and factors such as sex, height, weight, admission SBP, admission MAP, preoperative hemoglobin level, and preoperative blood calcium level. Multivariate logistic regression identified height [odds ratio (OR): 0.957; 95% confidence interval (CI): 0.924-0.991], admission SBP (OR: 0.979; 95% CI: 0.963-0.995), preoperative blood calcium concentration (OR: 0.044; 95% CI: 0.003-0.734), and the use of dexmedetomidine during surgery (OR: 0.278; 95% CI: 0.091-0.848) as independent risk factors for postoperative hypotension. CONCLUSIONS Height, admission SBP, preoperative blood calcium concentration, and the use of dexmedetomidine during surgery were identified as independent risk factors for postoperative hypotension in NPC patients undergoing endoscopic surgery. Identifying and addressing these factors can help clinicians optimize perioperative management by carefully titrating dexmedetomidine doses, ensuring adequate preoperative blood pressure control, and correcting calcium imbalances to maintain hemodynamic stability.
内镜手术在鼻咽癌（NPC）的治疗中变得越来越重要。然而，关于接受内镜手术的NPC患者术后低血压的研究有限。本回顾性研究旨在分析此类患者术后低血压的相关危险因素。
本回顾性研究纳入了2021年至2023年在广东省人民医院接受放疗后行内镜手术的NPC患者。收缩压（SBP）<90 mmHg或平均动脉压（MAP）<65 mmHg的患者被归入低血压组。进行多因素逻辑回归分析以确定与术后低血压相关的危险因素。
在264例患者中，86例（32.5%）出现术后低血压。单因素分析显示术后低血压与性别、身高、体重、入院时SBP、入院时MAP、术前血红蛋白水平和术前血钙水平等因素之间存在显著关联。多因素逻辑回归确定身高[比值比（OR）：0.957；95%置信区间（CI）：0.924 - 0.991]、入院时SBP（OR：0.979；95% CI：0.963 - 0.995）、术前血钙浓度（OR：0.044；95% CI：0.003 - 0.734）以及手术期间使用右美托咪定（OR：0.278；95% CI：0.091 - 0.848）为术后低血压的独立危险因素。
身高、入院时SBP、术前血钙浓度以及手术期间使用右美托咪定被确定为接受内镜手术的NPC患者术后低血压的独立危险因素。识别并处理这些因素有助于临床医生通过仔细调整右美托咪定剂量、确保术前血压得到充分控制以及纠正钙失衡来优化围手术期管理，以维持血流动力学稳定。
