血压脉搏波指数监测在老年腹腔镜手术患者全身麻醉中的应用价值  

Application of Blood Pressure Pulse Wave Index Monitoring in General Anesthesia of Elderly Patients Undergoing Laparoscopic Surgery

作　　者：吕纪璐 关庆来 LYU Ji-lu;GUAN Qing-lai(Department of Anesthesia,Shanghai Eighth People's Hospital,Shanghai 200030)

机构地区：[1]上海市第八人民医院麻醉科,上海200030 [2]复旦大学附属华山医院麻醉科,上海200040

出　　处：《医学临床研究》2022年第9期1375-1377,1381,共4页Journal of Clinical Research

摘　　要：【目的】探讨血压脉搏波指数监测在老年腹腔镜手术患者全身麻醉中的应用价值。【方法】两院收治的行全身麻醉腹腔镜手术的40例老年患者,分别于麻醉前、手术结束时、术后1周测量患者血压脉搏波指数,观察血压脉搏波数据及患者不同手术时段血压、心率的变化情况,并记录术后并发症的发生情况。【结果】患者手术结束时血压脉搏波指数中臂踝脉搏波传导速度(baPWV)、踝臂指数(ABI)较麻醉前均上升(P<0.05),而术后1周患者baPWV、ABI相较于麻醉前无明显变化(P>0.05)。气管插管时患者的收缩压(SBP)与舒张压(DBP)相较于术前均有所降低(P<0.05);切皮后、停药即刻时SBP、DBP相较于气管插管时均有所上升(P<0.05),但与术前相比较,差异均无统计学意义(P>0.05);气管插管时心率相较于术前上升(P<0.05),切皮后、停药即刻时心率相较于气管插管时均有所降低(P<0.05);但与术前相比较,差异均无统计学意义(P>0.05)。40例患者术后仅有2例(5.00%)患者出现缺血性心脏病,6例(15.00%)患者出现低氧血症,4例(10.00%)患者出现寒战,并发症发生率为30.00%(12/40)。【结论】老年患者全身麻醉腹腔镜手术围术期内血液脉搏波指数、血压、心率均有明显变化,而术后与术前均无明显变化,说明此变化暂时可发生逆转,临床上可利用血液脉搏波指数监测老年患者动脉血管情况,及早进行干预治疗,以缓解病情并降低并发症的发生率,提高手术的安全性。【Objective】To explore the significance of blood pressure pulse wave index monitoring in the perioperative period of general anesthesia in elderly patients undergoing laparoscopic surgery.【Methods】The blood pressure and pulse wave index of 40 elderly patients undergoing general anesthesia and laparoscopic surgery were measured before anesthesia,at the end of operation and one week after operation.The blood pressure and pulse wave data and the changes of blood pressure and heart rate in different operation periods were observed,and the occurrence of postoperative complications was recorded.【Results】The brachial ankle pulse wave velocity(baPWV)and ankle brachial index(ABI)in the blood pressure pulse wave index of the patients at the end of the operation were higher than those before anesthesia(P<0.05),but the baPWV and ABI of the patients at the end of the operation had no significant change compared with those before anesthesia(P>0.05).The systolic blood pressure(SBP)and diastolic blood pressure(DBP)were lower than those before endotracheal intubation(P<0.05);After skin cutting and immediately after drug withdrawal,SBP and DBP increased compared with that before endotracheal intubation(P<0.05),but there was no significant difference between them(P>0.05);The heart rate during endotracheal intubation was higher than that before operation(P<0.05),and the heart rate after skin incision and immediately after drug withdrawal was lower than that during endotracheal intubation(P<0.05);But there was no significant difference between them(P>0.05).Only 2(5.00%)patients had ischemic heart disease,6(15.00%)patients had hypooxia,4(10.00%)patients had chills,and the complication rate was 30.00%(12/40).【Conclusion】The blood pulse wave index,blood pressure and heart rate of the elderly patients during the peri operative period of general anesthesia and laparoscopic surgery have obvious changes,but there are no obvious changes after and before the operation;It indicates that this change can be reversed temporarily.In

关 键 词：腹腔镜检查 脉搏波分析 麻醉 全身 老年人 

分 类 号：R614.2[医药卫生—麻醉学]