颈动脉超声预测全麻诱导后血压变异率的价值  

Prediction of blood pressure variability after general anesthesia induced by carotid artery ultrasound

作　　者：刘珺[1] 谢斌[1] 龙燕[1] 黄桂明[1] 李以平[1] Liu Jun;Xie Bin;Long Yan;Huang Guiming;Li Yiping(Department of Anesthesiology,People's Hospital of Ganzhou,Ganzhou,Jiangxi,341000,China)

机构地区：[1]赣州市人民医院麻醉科,江西赣州341000

出　　处：《当代医学》2018年第11期9-12,共4页Contemporary Medicine

基　　金：赣州市指导性科技计划(GZ2017ZSF182)

摘　　要：目的探讨颈动脉超声预测全麻诱导后血压变异率的价值。方法选取本院2016年2月~2017年4月择期全麻下进行骨科手术的患者100例,根据患者血压状况分为正常血压组和高血压组,每组50例,所有患者均行舒芬太尼、依托咪酯和罗库溴铵进行麻醉诱导,两组患者麻醉诱导前后HR、收缩压(SBP)、舒张压(DBP)、平均动脉压(MAP)、右颈总动脉内径、左颈总动脉内径、右颈内动脉内径、左颈内动脉内径,比较两组患者全麻诱导前后HR、SBP、DBP、MAP、右颈总动脉内径、左颈总动脉内径、右颈内动脉内径、左颈内动脉内径变化,并采用ROC曲线对进行诊断价值评估的MAP、HR、颈动脉内径进行分析及各指标间的相关性分析。结果与正常血压组患者比较,高血压组患者HR、SBP、DBP、MAP、右颈总动脉内径、左颈总动脉内径、右颈内动脉内径、左颈内动脉内径明显升高,差异具有统计学意义(P<0.05);与诱导前比较,两组患者诱导后HR、SBP、DBP、MAP、右颈总动脉内径、左颈总动脉内径、右颈内动脉内径、左颈内动脉内径显著降低,差异具有统计学意义(P<0.05);与正常血压组患者诱导后比较,高血压组患者诱导后HR、SBP、DBP、MAP、右颈总动脉内径、左颈总动脉内径、右颈内动脉内径、左颈内动脉内径显著降低,差异具有统计学意义(P<0.05)。正常血压组MAP灵敏度为50.5%,特异度50.0%;HR灵敏度为83.4%,特异度55.0%;右颈总动脉内径灵敏度为87.8%,特异度75.0%;左颈总动脉内径灵敏度为85.7%,特异度75.0%;右颈内动脉内径灵敏度为87.2%,特异度75.0%;左颈内动脉内径灵敏度为86.6%,特异度75.0%。高血压组MAP灵敏度为59.8%,特异度100.0%;HR灵敏度为88.6%,特异度80.0%;右颈总动脉内径灵敏度为77.2%,特异度100.0%;左颈总动脉内径灵敏度为78.5%,特异度100.0%;右颈内动脉内径灵敏度为77.9%,特异度100.0%;左颈内动脉内径灵敏度为79.0%,特异度100.Objective To evaluate the value of carotid ultrasound in predicting the blood pressure variability after general anesthesia.Methods 100 patients of Department of orthopedics operation in our hospital from February 2016 to April 2017 under general anesthesia,according to blood pressure in patients were divided into normal blood pressure group and hypertension group,50 cases in each group,all patients underwent sufentanil,etomidate and rocuronium for induction of anesthesia,HR,systolic blood pressure before and after induction of anesthesia in two groups of patients(SBP)(DBP),diastolic blood pressure,mean arterial pressure(MAP),the right carotid artery diameter,left carotid artery diameter,right internal carotid artery diameter and left internal carotid artery diameter were compared between the two groups before and after induction of anesthesia,HR SBP,DBP,MAP,the right carotid artery diameter,left carotid artery diameter,right the change of carotid artery diameter and left internal carotid artery diameter,and analyses the correlation between each index and to evaluate the diagnostic value of MAP and HR,the diameter of the carotid artery by ROC curve.Results Compared with the normal blood pressure group,hypertension group were HR,SBP,DBP,MAP,the right carotid artery diameter,left carotid artery and right internal carotid artery diameter,diameter,diameter of left internal carotid artery was significantly increased,the difference was statistically significant(P<0.05);compared with before induction,two patients with HR after induction DBP,SBP,and MAP,the right carotid artery diameter,left carotid artery and right internal carotid artery diameter,diameter,diameter of left internal carotid artery was significantly decreased,the difference was statistically significant(P<0.05);and the normal blood pressure group patients after induction,hypertensive patients after induction of HR,SBP,DBP,MAP,the right carotid artery diameter,left carotid artery and right internal carotid artery diameter,diameter,diameter of left internal

关 键 词：颈动脉超声 全麻诱导 血压变异率 预测价值 

分 类 号：R614[医药卫生—麻醉学]