关键词: 颈动脉支架植入术, 血压管理, 围手术期, 护理

Abstract:

Objective To construct a perioperative blood pressure management plan for patients undergoing carotid artery stenting（CAS） and evaluate its application effectiveness，and to provide references for clinical practice. Methods The relevant literature on perioperative blood pressure management for CAS patients was retrieved from domestic and foreign databases，and a preliminary draft of a perioperative blood pressure management plan for CAS patients was constructed. The preliminary draft was discussed and modified through expert meetings，and 2 rounds of expert inquiries were conducted using the Delphi method from June 2023 to August 2023 to determine the final plan. 32 patients who received CAS in the neurology department of a tertiary comprehensive hospital in Zhejiang Province were selected from May to July 2024 as an experimental group，and 33 patients who received CAS in the same ward from January to March 2024 as a control group. The experimental group applied the constructed CAS patient perioperative blood pressure management plan，while the control group applied routine perioperative nursing measures. The incidence of postoperative hypertension，postoperative hypotension，and postoperative adverse events was compared between 2 groups. Results A total of 13 experts completed 2 rounds of inquiries. The effective questionnaire response rate for the second round of inquiry was 100%，with an authority coefficient of 0.897. The coefficients of variation for the importance and feasibility scores of each item were 0~0.19 and 0~0.18，respectively，and the Kendall harmony coefficients were 0.224 and 0.201，respectively（P<0.05）. The final construction plan includes 3 primary indicators，15 secondary indicators，and 40 tertiary indicators. Ultimately，32 cases were included in the experimental group and 33 cases in the control group. The incidence of postoperative hypertension，postoperative hypotension，and adverse events in the experimental group was lower than that in the control group，and the difference was statistically significant（P<0.05）. Conclusion The perioperative blood pressure management plan for CAS patients constructed in this study has good scientificity and practicality，which can improve the stability of patients’ perioperative blood pressure and reduce the occurrence of adverse events.

Key words: Carotid Artery Stenting, Blood Pressure Management, Perioperative Period, Nursing Care