连续无创动脉血压监测系统在心脏疾病患者麻醉中的应用价值  

Application value of continuous non-invasive arterial blood pressure monitoring system in anesthesia of patients with heart disease

作　　者：张金雄 欧霞 张孝华 ZHANG Jinxiong;OU Xia;ZHANG Xiaohua(Surgical Anesthesia Department,Maoming Hospital of Traditional Chinese Medicine,Maoming 525000,China;Respiratory Department,Maoming Hospital of Traditional Chinese Medicine,Maoming 525000,China;Anesthesia Department,Maoming Hospital of Traditional Chinese Medicine,Maoming 525000,China)

机构地区：[1]茂名市中医院手术麻醉科,广东茂名525000 [2]茂名市中医院呼吸内科,广东茂名525000 [3]茂名市中医院麻醉科,广东茂名525000

出　　处：《临床医学研究与实践》2022年第16期47-49,共3页Clinical Research and Practice

基　　金：茂名市科技计划项目(No.2019009)。

摘　　要：目的探讨连续无创动脉血压监测系统在心脏疾病患者麻醉中的应用价值。方法选择我院2020年1月至2021年1月收治的50例心脏疾病且择期行非心脏全麻手术的患者作为研究对象。在非优势手桡动脉穿刺动脉导管,置入有创压力监测传感器监测桡动脉有创血压(IBP),在优势手连接TL-300系统监测桡动脉无创血压(NIBP)。比较IBP与NIBP监测的操作平均耗时、监测满意度和不良反应发生情况。采用Bland-Altman分析评价IBP与NIBP监测的一致性,采用Pearson相关性分析评估IBP与NIBP监测的相关性。结果NIBP监测操作平均耗时短于IBP监测,监测满意度高于IBP监测,差异具有统计学意义(P<0.05);两种血压监测方法的不良反应总发生率比较,差异无统计学意义(P>0.05)。Bland-Altman一致性分析结果显示,两种方法监测SBP、DBP与MBP的偏倚均可满足美国国家标准学会和美国医疗器械促进协会(ANSI/AAMI)推荐的偏倚范围(±5 mmHg)和标准差范围(≤8 mmHg)。Pearson相关性分析结果显示,IBP与NIBP监测SBP、DBP、MBP均呈正相关(P<0.05)。结论NIBP与IBP监测具有较高的一致性和相关性,且NIBP可以为心脏疾病且择期行非心脏全麻手术的患者提供无创、实时、连续、准确的血压监测。Objective To explore the application value of continuous non-invasive arterial blood pressure monitoring system in anesthesia of patients with heart disease.Methods A total of 50 heart disease patients who underwent elective honcardiac general anesthesia surgery admitted in our hospital from January 2020 to January 2021 were selected as the research objects.The arterial catheter was punctured into the radial artery of the non dominant hand,the invasive pressure monitoring sensor was placed to monitor the invasive blood pressure(IBP)of the radial artery,and the TL-300 system was connected to the dominant hand to monitor the non-invasive blood pressure(NIBP)of the radial artery.The average operation time,monitoring satisfaction and occurrence of adverse reactions of IBP and NIBP monitoring were compared.Bland-Altman analysis was used to evaluate the consistency of IBP and NIBP monitoring,and Pearson correlation analysis was used to eveluate the correlation between IBP and NIBP monitoring.Results The average operation time of NIBP monitoring was shorter than that of IBP monitoring,the monitoring satisfaction was higher than that of IBP monitoring,and the differences were statistically significant(P<0.05);there was no significant difference in the total incidence of adverse reactions between the two blood pressure monitoring methods(P>0.05).Bland-Altman agreement analysis result showed that the bias of SBP,DBP and MBP monitored by the two methods could meet the bias range(±5 mmHg)and standard deviation range(≤8 mmHg).Pearson correlation analysis result showed that IBP was positively correlated with NIBP in monitoring SBP,DBP and MBP(P<0.05).Conclusion NIBP and IBP monitoring have higher consistency and correlation,and NIBP can provide non-invasive,real-time,continuous and accurate blood pressure monitoring for heart disease patients who undergoing elective honcardiac general anesthesia surgery.

关 键 词：心脏疾病 麻醉 TL-300系统 连续无创动脉血压监测系统 

分 类 号：R614[医药卫生—麻醉学]