胸科手术患者术前不同时点基础血压比较  

Comparison of blood pressure at different preoperative time points in patients undergoing thoracic surgery

作　　者：戴双波[1] 齐娟[1] DAI Shuang-bo;QI Juan(Anesthesiology DepartmentⅡ,Fujian Provincial Hospital,Fuzhou 350001,China)

机构地区：[1]福建省立医院麻醉二科,福建福州350001

出　　处：《吉林医学》2020年第11期2588-2591,共4页Jilin Medical Journal

摘　　要：目的:观察胸科手术患者术前不同时点基础血压,比较不同时点基础血压的差别,寻找术中血压调控基础值,为临床提供参考。方法:选取择期行胸科手术患者100例,ASA分级Ⅱ~Ⅲ级,男女不限,年龄不限。所有患者采集3个时点血压(SBP、DBP、MBP)和心率(HR):术前一天(T1)、入麻醉准备间(T2)、有创动脉穿刺后(T3),比较不同时点基础血压的差别,并以性别、年龄、是否合并高血压进行亚组分析。结果:与T1比较,所有患者SBP和MBP在T2和T3升高,T2时点SBP升高幅度为(6.8±10.8)mmHg,升高百分比为(5.6±8.6)%;T3时点SBP升高幅度为(19.2±18.4)mmHg,升高百分比为(15.6±15.2)%。以性别(男/女)、年龄(≤60岁/>60岁)、是否合并高血压病进行亚组分析:与T1比较,各亚组患者SBP在T2和T3升高;年龄>60患者和合并高血压病患者血压升高幅度高于年龄≤60患者和无合并高血压病的患者。结论:所有患者在入麻醉准备间和有创动脉穿刺后血压升高,高龄患者和合并高血压病患者的血压升高更为剧烈,建议以手术前一天血压做为术中血压调控的基础血压值。Objective To observe the blood pressure at different preoperative time points in patients undergoing thoracic surgery to compare the difference of basic blood pressure at different time points,and to find the basic value of intraoperative blood pressure regulation,so as to provide reference for clinical practice.Method Enrolled 100 patients undergoing thoracic surgery,ASAⅡ~Ⅲlevel.Blood pressure(SBP,DBP,MBP)and heart rate(HR)at three time points were collected from all patients:one day before surgery(T1),before anesthesia(T2),and after invasive arteriopuncture(T3).To compare the difference of basic blood pressure at different time points,subgroup analysis was conducted by gender,age and whether or not hypertension.Results Compared with T1,the SBP and MBP of all patients increased in T2 and T3,the SBP increased at T2 were(6.8±10.8)mmHg and(5.6±8.6)%,the SBP increased at T3 were(19.2±18.4)mmHg and(15.6±15.2)%.Subgroup analysis:compared with T1,the SBP of patients in each subgroup increased at T2 and T3.The value of SBP increased in patients aged>60 and patients with hypertension was higher than that in patients aged≤60 and patients without hypertension.Conclusion The blood pressure of all patients increased during anesthesia preparation and after invasive arteriopuncture,and the blood pressure of elderly patients and patients with hypertension increased more dramatically than that of young patients and non-hypertension patients.It is suggested that the blood pressure of the day before the operation should be taken as the basic blood pressure value for intraoperative blood pressure regulation.

关 键 词：胸科手术 基础血压 血压管理 

分 类 号：R655[医药卫生—外科学]