全身麻醉患者术毕至转运病房期间低血压危险因素分析  

Risk factors analysis for postoperative hypotension during the transition from recovery to transfer ward in patients undergoing general anesthesia

作　　者：朱昭平[1] 龚淑娟 张颖 何帆 杨银燕[1] 甘奇[1] 朱宇航 李光才[1] Zhu Zhaoping;Gong Shujuan;Zhang Ying;He Fan;Yang Yinyan;Gan Qi;Zhu Yuhang;Li Guangcai(Department of Anesthesiology,Guizhou Aerospace Hospital,Zunyi Guizhou 563000,China;Department of Anesthesiology,Affiliated Hospital of Zunyi Medical University.Zunyi Guizhou 563003,China)

机构地区：[1]贵州航天医院麻醉科,贵州遵义563000 [2]遵义医科大学附属医院麻醉科,贵州遵义563003

出　　处：《遵义医科大学学报》2024年第10期971-977,共7页Journal of Zunyi Medical University

基　　金：遵义市科技计划资助项目[NO:遵市科合HZ字(2024)113号],贵州航天医院科研基金资助项目(NO:gzhtyy-2023-2)。

摘　　要：目的分析全身麻醉患者术毕至转运病房期间发生术后低血压(PSH)的危险因素,探讨其对患者预测价值。方法募集231例全麻手术患者,观察手术结束、过床后1、3、5、10 min及入复苏室时、出复苏室时、回病房时是否出现PSH,分析性别、年龄、体重、BMI、基础疾病、麻醉方式、手术方式、术中出入量、BP、HR、RR、SpO 2等因素是否为PSH发生的危险因素。结果与入手术室时相比,手术结束后1、3、5、10 min,入复苏室时、出手术室时和进入病房时各时间点低血压患者发生率分别为29.44%、25.54%、20.35%、17.75%、16.45%、20.35%及22.94%例;与入手术室时相比,入复苏室时PSH组与非PSH组患者的体重、BMI、SBP及DBP有差异(P<0.05);与入手术室时相比,进入病房时PSH组与非PSH组患者的出血量、SBP、DBP及SpO 2有差异(P<0.05);多元线性回归分析显示,SBP为入复苏室时PSH发生的危险因素;出血量及SBP为进入病房时PSH发生的危险因素;ROC曲线分析结果显示,SBP对入复苏室时患者发生PSH具有较好的预测价值,预测值为89.5 mmHg;出血量及SBP对患者进入病房后发生PSH具有较好的预测价值。结论全身麻醉患者术前SBP及术中出血量为术毕PSH发生的危险因素,并对患者术毕返回病房后发生PSH具有良好的预测价值,预测值分别为150 mmHg和126.5 mmHg。Objective To analyze the risk factors of post-surgery hypotension(PSH)in patients undergoing general anesthesia after surgery and to explore its predictive value for patients.Methods A total of 231 patients undergoing general anesthesia were recruited,and the following time points were observed for possible PSH occurrence:at the end of surgery,1,3,5,10 min after crossing the bed,at the time of entering the resuscitation room,at the timeof exiting the resuscitation room,and at the time of returning to the ward.Whether gender,age,body weight,BMI,underlying disease,anesthesia mode,operation method,intraoperative access quantity,BP,HR,RR,and SpO 2 were the risk factors for the occurrence of PSH were also analyzed.Results The incidence of patients with PSH at each time point from the end of surgery to return to the ward was 29.44%,25.54%,20.35%,17.75%,16.45%,20.35%,and 22.94%,respectively.Compared with the time of admissionto the operating theatre,body weight,BMI,SBP,and DBP of the patients in the PSH group was statistically different from the non-PSH group at the time of admission to the resuscitation room.Compared with the time of admissionto the operating theatre,bleeding volume,SBP,DBP and SpO 2of the patients in the PSH group was statistically different from the non-PSH groupat the time of admission to the ward.Multiple linear regression analysis showed that SBP were risk factors for PSH at the time of admission to the resuscitation room.Bleeding volume and SBP were risk factors for the occurrence of PSH when entering the ward;ROC curve analysis showed that SBP had good predictive value for the occurrence of PSH in patientsat the time of admission to the resuscitation room,the predicted value is 89.5 mmHg.Bleeding volume,and SBP had good predictive value for the occurrence of PSH in patients after entering the ward.Conclusion SBP before operation and blood loss during operation wererisk factors for PSH after general anesthesia,which have a good predictive value for the development of PSH in patients returning to

关 键 词：全身麻醉 术后低血压 危险因素 预测 

分 类 号：R453.9[医药卫生—治疗学]