摘要
目的探讨非心脏外科择期手术患者手术室发生高血压危象的影响因素。方法选择2021年6月~2022年6月在我院行非心脏择期手术,入手术室发生高血压危象(血压超过180/110 mm Hg),导致择期手术延迟的患者为病例组。采用1∶3配对病例-对照研究设计,选择同期未发生入手术室高血压危象的患者为对照组。采用单因素分析和多因素logistic回归分析筛选手术室发生围术期高血压危象的影响因素。结果单因素分析显示BMI、术前高血压分级、高血压危险分层、低密度脂蛋白、脑血管疾病史差异有显著性(P<0.05)。将有显著性差异的变量纳入多因素logistic逐步回归分析,结果显示术前2级高血压(OR=39.316,P=0.031)、3级高血压(OR=102.042,P=0.008)、脑血管疾病史(OR=3.482,P=0.015)、低密度脂蛋白水平升高(OR=1.504,P=0.007)是入手术室发生高血压危象的独立影响因素。结论患者术前较高的高血压分级(2级或3级)、脑血管疾病史、低密度脂蛋白水平升高是非心脏外科择期手术患者入手术室发生高血压危象的影响因素。
Objective To explore the influencing factors of perioperative hypertension crisis in operating room in non-cardiac surgery patients undergoing selective surgery.Methods The patients who underwent non-cardiac selective surgery in our hospital from June 2021 to June 2022 and suffered from hypertension crisis(blood pressure exceeding 180/110 mm Hg)in operating room resulting in delayed selective surgery were selected as the case group.A 1∶3 matched case-control study design was used to select patients who did not have hypertension crisis in operating room as the control group.Univariate analysis and multivariate logistic regression analysis were used to screen the influencing factors of perioperative hypertension crisis in operating room.Results Univariate analysis showed that there were significant differences in BMI,preoperative hypertension classification,hypertension risk stratification,low density lipoprotein,and cerebrovascular disease(P<0.05).The variables with significant differences were included in the multivariate logistic stepwise regression analysis.The results showed that preoperative grade 2 hypertension(OR=39.316,P=0.031),grade 3 hypertension(OR=102.042,P=0.008),history of cerebrovascular disease(OR=3.482,P=0.015),and elevated low density lipoprotein level(OR=1.504,P=0.007)were independent influencing factors for the occurrence of hypertension crisis in operating room.Conclusion High preoperative hypertension classification(grade 2 or 3),cerebrovascular disease,and high level of low density lipoprotein level are influencing factors of hypertension crisis in operating room in non-cardiac surgery patients undergoing selective surgery.
作者
韩彬
鲍林
贾茜茜
郭向阳
Han Bin;Bao Lin;Jia Xixi(Department of Anesthesiology,Peking University Third Hospital,Beijing 100191,China)
出处
《中国微创外科杂志》
CSCD
北大核心
2023年第3期180-185,共6页
Chinese Journal of Minimally Invasive Surgery
基金
北京大学第三医院创新转化基金项目(BYSYZHZB2022104)。
关键词
围术期高血压危象
高血压分级
脑血管病
低密度脂蛋白
Perioperative hypertension crisis
Hypertension classification
Cerebrovascular disease
Low density lipoprotein
