临床麻醉中血压问题是经常要面对的，高血压或低血压的原因很多，比如既往有高血压病史，或者术晨没有继续服用降压药，或者比较紧张焦虑，或者麻醉深度与手术刺激不匹配，或者不良神经反射等等，但没有意识到肿瘤患者术前放化疗也会影响血压，到底是什么样的影响呢？让我们来看看这篇发表在Head Neck杂志上的文章Patterns of blood pressure changes in patients with head and neck cancer receiving radiotherapy orchemo-radiotherapy at a tertiary cancer centre都得出了什么样的结果。

在三级癌症中心接受放疗或放化疗的头颈部癌症患者的血压变化模式

※※※※※※背景：※※※※※※

评价头颈部癌症（head and neck cancer ，HNC）患者接受放疗（radiotherapy，RT）/放化疗（chemo-radiotherapy，CRT）后血压的变化规律。

※※※※※※方法：※※※※※※

对451例连续接受RT/CRT治疗的HNC患者进行资料收集、整理和分析。

这是临床试验流程图:

这时患者的基线数据及放化疗情况：

※※※※※※结果：※※※※※※

451例患者中，男性376例（82%），女性75例（18%），中位年龄52岁。

这时血压及体重的变化情况：

与接受IMRT-IGRT的患者相比，接受3DCRT的患者血压下降幅度更大，包括收缩压和平均动脉压（MAP）。女性患者舒张压下降幅度大于男性患者（p=0.03）。在治疗结束时，我们观察到收缩压下降（降低基线的10%）和体重减轻超过基线体重的10%之间存在显著的相关性（p=0.03）。

※※※※※※结论：※※※※※※

RT/CRT期间血压下降受治疗技术和性别的显著影响，并与体重显著下降密切相关。

Patterns of blood pressure changes in patients with head andneck cancer receiving radiotherapy or chemo-radiotherapy at a tertiary cancercentre

Background: To evaluate patternsof blood pressure (BP) changes in patients with head and neck cancer (HNC)receiving radiation (RT)/chemo-radiation (CRT)

METHODS: This study includeddata collection, compilation, and analysis of 451 consecutive HNC patients whounderwent RT/CRT.

Results: Out of 451 patients, 376 (82%) were maleand 75 (18%) were female with a median age of 52 years. Patients receiving3DCRT experienced greater fall in BP, including for SBP and MAP, compared tothose receiving IMRT-IGRT. Female patients experienced greater fall in diastolicBP as compared to male patients (p: 0.03). At the end of treatment, we observeda significant association between a fall in systolic BP (decrease by 10% ofbaseline) and weight loss of more than 10% of baseline weight (p: 0.03).

Conclusion: Fall in BP duringRT/CRT is significantly affected by treatment technique and sex and is stronglyassociated with significant weight loss.