急性多发伤复合伤合并休克早期患者有创动态血压与无创血压监测的对比研究  

Comparative Study of Invasive and Noninvasive Blood Pressure Monitoring in Patients with Acute Multiple Injuries Combined with Early Shock

作　　者：孟艳婕 Meng Yanjie(The First Affiliated Hospital of Chengdu Medical College,Chengdu 610500,China)

机构地区：[1]成都医学院第一附属医院,新都610500

出　　处：《成都医学院学报》2023年第4期493-497,共5页Journal of Chengdu Medical College

摘　　要：目的 探讨急性多发伤复合伤合并休克早期患者有创动态血压(IBP)与无创血压(NIBP)监测的差异。方法 选取2020年1月至2021年4月成都医学院第一附属医院收治的65例急性多发伤复合伤合并休克早期患者为研究对象。在入院当时至入院24 h实施IBP持续血压监测;在入院当时,入院12、24 h使用水银血压计测量NIBP。比较各时间点IBP和NIBP测量的血压值差异,分析IBP测量的血压值与血氧饱和度(SaO_(2))、血乳酸、格拉斯哥昏迷评分(GCS)、急性生理与慢性健康评分(APACHE-Ⅱ)的相关性。结果 IBP测量的收缩压和舒张压均低于NIBP测量值(P<0.05)。IBP测量的收缩压、舒张压、脉压差与NIBP测量值均呈正相关(r=0.955、r=0.902、r=0.981,P<0.05)。IBP测量的血压值与SaO2、GCS评分呈正相关(r=0.337、r=0.309,P<0.05);与血乳酸水平、APACHE-Ⅱ评分呈负相关(r=—0.564、r=—0.412,P<0.05)。结论 相比NIBP,IBP监测可提供准确、及时的动态血压参数,在急性多发伤复合伤合并休克早期患者的抢救治疗中更具优势。Objective To explore the difference between invasive blood pressure(IBP)and non-invasive blood pressure(NIBP)monitoring in patients with acute multiple injuries combined with early shock.Methods A total of 65 patients with acute multiple injuries combined with early shock admitted to the First Affiliated Hospital of Chengdu Medical College from January 2020 to April 2021 were selected as the research subjects.IBP monitoring was continuously performed from admission to 24 h after admission,and NIBP monitoring was performed with a mercury sphygmomanometer at admission,and 12 h and 24 h after admission.The differences of blood pressure measured by IBP and NIBP methods at each time point were compared.The correlation between IBP measured blood pressure and arterial oxygen saturation(SaO_(2)),blood lactate,Glasgow coma scale(GCS)scores,and acute physiology and chronic health evaluationⅡ(APACHE-Ⅱ)scores were compared.Results Both systolic and diastolic blood pressure measured by IBP method were lower than those measured by NIBP method(P<0.05).The systolic blood pressure,diastolic blood pressure,and pulse pressure difference measured by IBP method were positively correlated with those measured by NIBP method(r=0.955,r=0.902,r=0.981,P<0.05).The blood pressure measured by IBP method was positively correlated with SaO2 and GCS score(r=0.337,r=0.309,P<0.05),and negatively correlated with blood lactate level and APACHE-Ⅱscore(r=-0.564,r=-0.412,P<0.05).Conclusion IBP monitoring provides more accurate,timely and dynamic blood pressure parameters than NIBP monitoring,and has more advantages in the rescue and treatment of patients with acute multiple injuries combined with early shock.

关 键 词：休克 多发伤 复合伤 有创动态血压 无创血压 

分 类 号：R605.971[医药卫生—急诊医学]