The Analysis On The Relations Among The Invasive BPV,HRV And Clinical Prognosis During The Perioperative Period

Objective: By distinguishing the relations among the patients' invasive arterial blood pressure variability,heart rate variability and clinical prognosis during the perioperative period,it can provide some references for clinicians to operate the clamping operations and take care of the patients;decrease the rate of the dead and the disabled among this kind of patients.So the quality of the patient's life can be improved.Methods: A retrospective analysis was conducted on the clinical information of 40 patients with aSAH treated by transcranial clipping in Handan Central Hospital between September 2018 and September 2019.The modified Rankin scale score at 3 months after onset was used as the clinical prognostic evaluation and grouping criteria.SPSS 25 software was used to establish a database,analyze and test the differences in basic data,blood pressure variability and heart rate variability between the two groups,and P<0.05 was used to describe the differences with statistical significance.Finally,the degree of prognosis was used as the dependent variable,and relevant indicators significant in univariate analysis were used as independent variables.Multivariate logistic regression analysis and test were performed.P<0.05 was used to describe the statistically significant difference.Results: The prognosis of 27 cases was good.The prognosis of 13 cases was poor,and 0 cases died.Statistical analysis showed that the differences in age and history of hypertension were statistically significant.The blood pressure variability of the group with good prognosis was lower than that of the group with poor prognosis,and the difference was statistically significant.The heart rate variability index of the group with good prognosis was significantly higher than that of the group with poor prognosis,and the differences were statistically significant in SDNN,SDANN,RMSSD and PNN50.There was no significant difference in TRI.After introducing the multivariate Logistic regression analysis variable model,it was found that nSSD was an independent risk factor for the degree of prognosis after 3 months,while SDNN,SDANN,RMSSD and PNN50 were independent protective factors for the degree of prognosis after 3 months,with P<0.05,the difference was statistically significant.Conclusions: In the perioperative period of craniotomy clipping in patients with aSAH.Both blood pressure variability and heart rate variability are related factors affecting the prognosis of such patients.Among them,nSSD was an independent risk factor for prognosis.SDNN,SDANN,RMSSD and PNN50 were independent protective factors for prognosis.Therefore,during the perioperative period of aSAH patients undergoing craniotomy clipping,strengthening the monitoring of blood pressure and trying to keep the blood pressure stable are necessary.Heart rate variability analysis can quantitatively evaluate the changes of autonomic nerve function in perioperative period of aSAH patients undergoing craniotomy clipping,so as to predict the occurrence of adverse cardiovascular and cerebrovascular events and provide certain reference value for their prognosis.It is still necessary to expand the sample size,refine the stratification,and conduct further studies in hospitals of the same level.Constantly optimize and improve the research content in practice.