全麻手术患者围术期下肢有创血压与无创血压的一致性分析  

Consistency of perioperative invasive blood pressure measurement with non-invasive blood pressure measurement for lower extremities in patients undergoing general anesthesia

作　　者：衣晓卓[1] 李天发[1] 王红霞[1] 夏豪[2] 周期[1] 

机构地区：[1]海南医学院附属医院麻醉科,海口市570102 [2]武汉大学人民医院心血管内科,武汉市430060

出　　处：《广西医学》2016年第1期20-22,共3页Guangxi Medical Journal

基　　金：国家自然科学基金(81460070)

摘　　要：目的分析全麻手术患者围术期下肢有创血压与无创血压的一致性。方法选取行神经外科手术的患者30例，均行静脉全身麻醉。术中及术后同时监测患者脚踝部的无创血压及同侧足背动脉的有创血压，对两种血压进行比较。结果在手术开始后0～4h内，有创测量脚踝部的收缩压及舒张压测量值均高于无创测量（P〈0．05），在手术开始后4～16h，两种测量方法的收缩压及舒张压测量值比较，差异无统计学意义（P〉0．05）。两种测量方法对全麻手术患者围术期下肢收缩压及舒张压的监测一致性均好（Kappa=0．70，0．79）。结论监测全麻手术患者围术期下肢无创血压和有创血压一致性好，但仍存在一定差异，在手术中要根据患者的具体情况选取血压的测量方式。Objective To analyze the consistency of perioperative invasive blood pressure measurement with non-invasive blood pressure measurement for lower extremities in patients undergoing general anesthesia. Methods Thirty patients receiving neurosurgery were enrolled and underwent intravenous general anesthesia. The non-invasive blood pressure of the ankle and the invasive blood pressure of the ipsilateral dorsal artery were monitored in all cases during surgery and after surgery. The results of the two blood pressure measurements were compared. Results Within 0 -4 hours after the surgery starting, the systolic blood pressure and diastolic blood pressure of the ankle measured by the invasive method were higher than those measured by the non-invasive method（P 〈 0.05）. Within 4 - 16 hours after the surgery starting, there was no significant difference in the systolic blood pressure or diastolic blood pressure between two methods. For patients undergoing general anesthesia, good consistency existed between the two measurements for perioperative systolic blood pressure and diastolic blood pressure of lower extremities （ Kappa = 0.70,0.79）. Conclusion For patients undergoing general anesthesia, non-invasive blood pressure measurement is consistent with iuvasive blood pressure measurement for perioperative blood pressure of lower extremities. However,difference still exists between the two methods, therefore the blood pressure measurement should be chosen according to the specific circumstances of the patients during surgery.

关 键 词：全麻手术 围术期 有创血压 无创血压 下肢 一致性 

分 类 号：R614.2[医药卫生—麻醉学]