摘要
目的:通过比较围手术麻醉期冠心病患者在不同时刻有创血压(invasive blood pressure,IBP)和无创血压(noninvasive blood pressure,NBP)监测在SBP、DBP的相关性和差异,为围术期冠心病患者的血压管理提供依据。方法:前瞻性收集2019年7月至2022年1月,北京安贞医院择期行非心脏手术的冠心病患者166例。其中男92例,女74例,年龄45~81岁,平均年龄(59.6±9.3)岁;BMI(23.2±3.0)kg/m2。患者进入手术室后当血压平稳时(T1)、麻醉诱导后血压平稳时(T2)、术后ICU血压平稳时(T3)记录患者两种不同方法同时测量同一上肢的血压值,分析IBP与NBP的相关性、一致性和区别等。结果:在T1、T2、T3时刻,同无创收缩血压、无创舒张血压相比,有创收缩血压、有创舒张血压均大,差异有统计学意义(t=23.05,P=0.0001,t=39.36,P=0.00001,t=3.06,P=0.006,t=1.66,P=0.004,t=14.88,P=0.0001,t=11.89,P=0.0001)。在T1、T2、T3时刻,SBP、DBP在有创法和无创法测量的结果均呈显著正相关(r=0.703,P=0.0001,r=0.801,P=0.0001,r=0.568,P=0.001,r=0.408,P=0.011,r=0.807,P=0.0001,r=0.757,P=0.0001)。在T1时刻,NBP、IBP的高血压比例分别是48%、62%,二者差异有统计学意义(χ^(2)=5.886,P=0.015);在T2时刻,NBP、IBP的高血压比例分别是12%、22%,二者差异有统计学意义(χ^(2)=12.736,P=0.001);在T3时刻,NBP、IBP的高血压比例分别是41%、54%,二者差异有统计学意义(χ^(2)=5.32,P=0.023)。结论:冠心病患者在术前、术中及术后IBP均高于NBP,两者间正相关性。在临床中,麻醉医生可以根据医疗机构条件、自己技术水平、外科手术大小和患者循环状况选择合理的测压方式。
Objective:To provide a basis for blood pressure management in patients with coronary artery disease during perioperative anesthesia by comparing the correlation and differences between invasive blood pressure(IBP)and noninvasive blood pressure(NBP)monitoring in SBP and DBP at different moments.Methods:A total of 166 patients with coronary heart disease who underwent elective non-cardiac surgery at Beijing Anzhen Hospital of Capital Medical University from July 2019 to Month 2022 were prospectively collected.There were 92 male and 74 female cases,aged 45-81 years;BMI(23.2±3.0)kg/m^(2).Blood pressure values of patients measured simultaneously by two different methods were recorded after patients entered the operating room when blood pressure was stable(T1),when blood pressure was stable after induction of anesthesia(T2),and when blood pressure was stable in the postoperative ICU(T3),and paired-sample t-test,Pearson correlation to analyze the correlation,consistency and difference between IBP and NBP.Results:At the moments of T1,T2 and T3,invasive systolic and diastolic blood pressure were greater compared with non-invasive systolic and diastolic blood pressure,and the differences were statistically significant(t=23.05,P=0.0001,t=39.36,P=0.00001,t=3.06,P=0.006,t=1.66,P=0.004,t=14.88,P=0.0001,t=11.89,P=0.0001);correlation test:at the moments of T1,T2 and T3,SBP and DBP showed significant positive correlation between invasive and non-invasive measurements(r=0.703,P=0.0001,r=0.801,P=0.0001,r=0.568,P=0.001,r=0.408,P=0.011,r=0.807,P=0.0001,r=0.757,P=0.0001).At the moment of T1,the proportion of hypertension in SBP and DBP was 48%and 62%,respectively,and the difference between them was not statistically significant(χ^(2)=5.886,P=0.015);at the moment of T2,the proportion of hypertension in SBP and DBP was 12%and 22%,respectively,and the difference between them was statistical significance(χ^(2)=12.736,P=0.001);at the moment of T3,the proportion of hypertension of SBP and DBP were 41%and 54%,respectively,and the differen
作者
刘文君
李红
林多茂
马骏
LIU Wenjun;LI Hong;LIN Duomao;MA Jun(Center for Anesthesiolosy,Beijing Anzhen Hospital,Capital Medical University,Beijing Institute of Heart,Lung and Blood Vessel Diseases,Beijing 100029,China)
出处
《心肺血管病杂志》
CAS
2023年第6期600-604,共5页
Journal of Cardiovascular and Pulmonary Diseases
基金
国家自然科学基金(82172151)。
关键词
有创血压
无创血压
冠心病
非心脏手术
Invasive blood pressure
Noninvasive blood pressure
Coronary heart disease
Noncardiac surgery.
