连续无创动脉血压监测系统在心脏病患者麻醉中的应用  

Application of Continuous Non-Invasive Arterial Pressure Monitoring System in General Anesthesia in Patients with Heart Disease

作　　者：谢春梅 陈世彪[1] 刘梅[1] 

机构地区：[1]南昌大学第一附属医院麻醉科,南昌330006

出　　处：《南昌大学学报（医学版）》2017年第5期36-40,共5页Journal of Nanchang University：Medical Sciences

基　　金：江西省科技厅科技支撑计划项目(20142BBG70059)

摘　　要：目的评估连续无创实时血压监测系统(TL-300tensymeter系统,TL-300)在心脏病患者麻醉中应用的可行性、准确性及安全性。方法选择全身麻醉下行择期心脏病手术成年患者40例,美国麻醉医师协会(ASA)Ⅲ~Ⅳ级,比较TL-300所测无创动脉血压(NIBP)与有创A-Line所测有创桡动脉血压(IBP)值的相关性和一致性。麻醉诱导前无菌操作局麻下行左手桡动脉穿刺动脉导管置入监测IBP,于右手桡动脉处连接TL-300监测NIBP,术中同时测量IBP和NIBP,间隔5min记录IBP及相应时点NIBP所测收缩压(SBP)、舒张压(DBP)和平均压(MBP),术后随访两种血压监测系统相关的并发症等。结果 NIBP与IBP所测SBP、MBP和DBP的偏倚分别为2.08、-1.30、-2.60,标准差分别为9.16、6.61、7.03,两者所测SBP、MBP和DBP的相关系数分别为0.852、0.806和0.752(均P<0.001)。所有患者均未发生局部感染、肢体缺血、假性动脉瘤、感觉异常等。结论与ALine相比,TL-300在成年心脏病手术患者全身麻醉中,可进行连续、无创、准确、安全的血压监测,心脏病患者在行中小型非心脏手术时可以由TL-300进行血压监测。Objective To evaluate the feasibility,accuracy and safety of TL-300 tensymeter system in general anesthesia in patients with heart disease.Methods Forty ASA Ⅲ-Ⅳ patients undergoing elective surgery for heart disease under general anesthesia were selected in this study. The correlation and consistency of non-invasive blood pressure（NIBP）and invasive blood pres-sure（IBP）were analyzed.Before anesthesia induction,a catheter was placed into the left radial ar-tery under local anesthesia to monitor the IBP and the TL-300 tensymeter system was connected to the right arm to monitor the NIBP.Both IBP and NIBP（systolic blood pressure（SBP）,diastolic blood pressure（DBP）and mean blood pressure（MBP））were recorded every 5 minutes.Blood pressure monitoring-related complications were observed postoperatively.Results The difference between IBP and NIBP was（2.08±9.16）,（-1.30±6.61）and（-2.60±7.03）mmHg for SBP, MBP and DBP,respectively.The correlation coefficient between IBP and NIBP was 0.852,0.806 and 0.752 for SBP,MBP and DBP,respectively（P 〈 0.001）.No local infection,limb ischemia,pseudoaneurysm and paresthesia were found in all patients.Conclusion Compared with A-Line, TL-300 tensymeter system provides continuous,non-invasive,accurate and safe blood pressure monitoring.Therefore,TL-300 can be used for arterial pressure monitoring in general anesthesia in heart disease patients undergoing small and medium non-cardiac surgery.

关 键 词：TL-300 连续无创血压 心脏病患者 连续有创血压 全身麻醉 

分 类 号：R614.24[医药卫生—麻醉学]