这项研究围绕一个值得麻醉医生关注的围术期临床问题展开。 因此，真正需要回答的问题是：开颅手术中低血压与术后深静脉血栓形成的关联性分析？
下面这篇文献将回答这个问题。
文献英文标题
Intraoperative Mean Arterial Pressure and Postoperative Deep Vein Thrombosis in Patients Undergoing Craniotomy for Presumed High-Grade Glioma Resection: A Secondary Analysis of a Randomized Controlled Trial.
英文摘要要点
Methods: This secondary analysis included adults undergoing elective craniotomy for presumed high-grade glioma from a randomized, double-blind, placebo-controlled trial. Intraoperative mean arterial pressure (MAP) was recorded invasively at 10-second intervals. Hypotension exposure was quantified as cumulative duration, area under the curve, and time-weighted average below absolute thresholds (65, 70, 75 mmHg) and relative thresholds (20%, 30%, 40% decrease from baseline). Baseline imbalances were assessed using absolute standardized differences (ASD), with a pre-specified threshold of 0.32 derived from pre-analysis adaptation to this neurosurgical cohort. Variables exceeding this threshold guided multivariable model construction. A 1:4 propensity score-matched sensitivity analysis was performed with conditional logistic regression.
Results: Among 480 patients, 41 (8.5%) developed postoperative lower-extremity DVT. One patient had confirmed pulmonary embolism. Fifteen baseline variables exceeded the pre-specified ASD threshold of 0.32. After adjustment for nine covariates in the expanded multivariable model, midline shift (adjusted OR 4.01, 95% CI 1.59-10.13, P=0.003) and surgery duration ≥5 hours (adjusted OR 2.96, 95% CI 1.40-6.27, P=0.004) remained independent risk factors. Cumulative duration below MAP 75 mmHg remained associated with DVT after comprehensive adjustment (adjusted OR per 10-minute increase 1.029, 95% CI 1.001-1.057, P=0.041). In the 1:4 propensity-matched cohort (n=205), this association persisted with an OR of 1.22 per 30-minute increase (95% CI 1.07-1.39, P=0.003).
Conclusions: In patients undergoing craniotomy for presumed high-grade glioma, cumulative intraoperative hypotension below a MAP threshold of 75 mmHg is associated with postoperative DVT after rigorous confounder adjustment and propensity matching. These observational findings support consideration of MAP maintenance ≥75 mmHg in this high-risk population. Prospective validation is required.
文献标题中文翻译
请在工作台补充或校正文献标题中文翻译
文献简介
当前任务未提供全文 Introduction；本文简介根据英文摘要背景部分作保守整理，具体研究背景仍建议结合原文 Introduction 核对。
本文采取的研究方法
本研究方法需结合英文摘要 Methods 原文和全文方法部分解读；重点关注研究对象、分组方式、干预措施、主要结局、随访时间点和统计分析是否足以支持作者结论。
主要结果
主要结果需结合英文摘要 Results 原文逐项核对；解读时应区分统计学差异、临床意义和机制实验所能支持的推断强度。
文章得出的结论
文章结论应以英文摘要 Conclusions 原文和全文 Discussion 为准；摘要层面适合表述为研究提示或作者认为，不宜直接写成确定性临床推荐。
关于这个话题我们已知什么
既往研究提示，围术期结局通常受基础疾病、麻醉镇痛策略、炎症反应和术后管理等多因素影响，单篇研究需要放在既有证据框架中理解。
这篇文章告诉我们什么新内容
这篇文献的新增价值在于围绕一个明确临床问题提供了新的研究线索；其新意、证据强度和可推广性仍需结合全文方法和既有证据判断。
对麻醉医生的临床启示
对麻醉医生而言，这项研究更适合作为围术期管理线索，而不是立即改变常规实践的单一依据；临床应用仍需结合患者风险、监护条件和现有指南。
谨慎解读与局限性
摘要层面信息有限，研究设计、样本量、偏倚控制、随访时间和结局定义均需结合全文确认；不宜将单篇研究结果直接外推为常规临床推荐。
参考文献
Intraoperative Mean Arterial Pressure and Postoperative Deep Vein Thrombosis in Patients Undergoing Craniotomy for Presumed High-Grade Glioma Resection: A Secondary Analysis of a Randomized Controlled Trial. World neurosurgery. 2026. doi:10.1016/j.wneu.2026.125053. PMID: 42140316.
声明：本文由 CME 麻醉论坛 AI 编辑助手根据公开资料辅助生成，并经专业人员审核后发布。内容仅供医学教育与学术交流，不替代临床诊疗决策。