摘要
目的探讨超声联合脉搏氧灌注指数(PI)对全身麻醉(以下简称全麻)诱导后低血压发生的预测价值。方法选取在我院行全麻诱导外科手术的患者158例,根据全麻诱导后是否发生低血压分为低血压组69例和非低血压组89例,比较两组一般资料[PI、PI增加率、平均动脉压(MAP)、收缩压(SBP)、舒张压(DBP)]、诱导前后下腔静脉(IVC)内径最大值和最小值(IVCmax、IVCmin)、锁骨下静脉(SCV)内径最大值和最小值(SCVmax、SCVmin)及IVC内径变异度(IVCCI)、SCV内径变异度(SCVCI)的差异。绘制受试者工作特征(ROC)曲线评估各参数单独及联合应用预测全麻诱导后低血压发生的预测价值。结果低血压组诱导前后PI、PI增加率均高于非低血压组,诱导后MAP、SBP、DBP均低于非低血压组,差异均有统计学意义(均P<0.05)。低血压组诱导前SCVCI和IVCCI均高于非低血压组,SCVmax、SCVmin、IVCmax、IVCmin均低于非低血压组,差异均有统计学意义(均P<0.05)。ROC曲线分析显示,诱导前PI、诱导后PI、PI增加率、SCVmin、SCVmax、SCVCI、IVCmin、IVCmax、IVCCI预测全麻诱导后低血压发生的曲线下面积分别为0.710、0.805、0.877、0.795、0.821、0.633、0.835、0.768、0.846,各参数联合应用的曲线下面积为0.938。结论超声联合PI对全麻诱导后低血压的发生具有一定预测价值,可为临床预防低血压的发生提供参考。
Objective To investigate the predictive value of ultrasound combined with pulse oxygen perfusion index(PI)in general anesthesia-induced hypotension.Methods A total of 158 patients who underwent surgery induced by general anesthesia in our hospital were selected,and they were divided into hypotension group(69 cases)and non-hypotension group(89 cases)according to whether patients suffered hypotension after general anesthesia.The general data[PI,PI increasing rate,mean arterial pressure(MAP),systolic blood pressure(SBP),diastolic blood pressure(DBP)]of the two groups were compared,as well as the maximum and minimum values of inferior vena cava diameter(IVCmax,IVCmin),the inferior vena cava diameter collapsibility index(IVCCI),the maximum and minimum values of subclavian vein diameter(SCVmax,SCVmin),the subclavian vein diameter collapsibility index(SCVCI).Receiver operating characteristic(ROC)curve was drawn to analyze the predictive value of parameters application alone and combined for hypotension after general anesthesia.Results Basal PI,post-induction PI and PI increasing rate in hypotension group were higher than those in non-hypotension group,and MAP,SBP and DBP after induction were lower than those in non-hypotension group,the differences were statistically significant(all P<0.05).Basal SCVCI and IVCCI in hypotension group were higher than those in non-hypotension group,SCVmax,SCVmin,IVCmax and IVCmin were lower than those in non-hypotension group,the differences were statistically significant(all P<0.05).ROC curve analysis showed that the area under the curve of basal PI,post-induction PI,PI increasing rate,SCVmin,SCVmax,SCVCI,IVCmin,IVCmax and IVCCI in predicting hypotension after general anesthesia were 0.710,0.805,0.877,0.795,0.821,0.633,0.835,0.768 and 0.846,respectively,and the area under the curve predicted by the combination of the parameters was 0.938.Conclusion Ultrasound combined with PI has a certain value in predicting hypotension induced by general anesthesia and can guide clinical prevention of hypotension.
作者
郑得全
陈坛寿
陈文斌
卓庆亮
ZHENG Dequan;CHEN Tanshou;CHEN Wenbin;ZHUO Qingliang(Department of Anesthesiology,Ningde Municipal Hospital of Ningde Normal University,Fujian 352100,China)
出处
《临床超声医学杂志》
CSCD
2023年第3期221-224,共4页
Journal of Clinical Ultrasound in Medicine
关键词
超声检查
脉搏氧灌注指数
全身麻醉
低血压
预测价值
Ultrasonography
Pulse oxygen perfusion index
General anesthesia
Hypotension
Predictive value
