摘要
目的探究颈动脉校正血流时间(FTc)对急诊创伤患者气管插管后低血压预测价值。方法选取2021年1月至2022年12月于本院收治的110例急诊创伤患者,其中,有5例患者因转院、死亡等退出本次研究,最终有105例患者纳入,并将其按插管后是否出现低血压分为35例低血压组、70例非低血压组,均在麻醉前超声检测,观察颈动脉FTc,统计分析临床基本资料。对比两组血流动力学指标变化,分析急诊创伤患者气管插管后发生低血压的风险因素及颈动脉FTc急诊创伤患者气管插管后低血压的预测价值。结果经单因素分析显示,急诊创伤患者气管插管后低血压发生情况主要与年龄、插管前平均动脉压(MAP)、动脉血氧饱和度、急性生理与慢性健康评分(APACHEⅡ)评分、休克指数(SI)有关(P<0.05)。与非低血压组对比,低血压组的心率(HR)、舒张压(DBP)、收缩压(SBP)、FTc水平表达有所升高(P<0.05)。以急诊创伤患者气管插管后发生低血压情况为因变量,选单因素分析中P<0.05的变量为自变量行多因素Logistic回归分析,结果发现,年龄、动脉血氧饱和度、插管前MAP、APACHEⅡ评分为急诊创伤患者气管插管后低血压发生的主要危险因素(P<0.05)。颈动脉FTc对急诊创伤患者气管插管后低血压预测有较高的的临床价值(P=0.001)。结论观察急诊创伤患者气管插管后血流动力学相关指标的水平变化,通过颈动脉FTc可有效提高对急诊创伤患者气管插管后低血压的预测价值。
Objective To investigate the value of carotid corrected flow time(FTc)in predicting hypotension after tracheal intubation in emergency trauma patients.Methods A total of 110 emergency trauma patients admitted to the emergency department of our hospital from January 2021 to December 2022 were selected,among which 5 patients withdrew from the study due to hospital transfer or death,and 105 patients were finally included.According to whether hypotension occurred after intubation,they were divided into the hypotensive group(35 patients)and the non-hypotensive group(70 patients),all of which were examined by ultrasound before anesthesia.Carotid FTc was observed and the basic clinical data were statistically analyzed.The risk factors of hypotension after endotracheal intubation in emergency trauma patients and the predictive value of endotracheal intubation hypotension in carotid FTc emergency trauma patients were analyzed by comparing the changes of hemodynamic indexes between the two groups.Results Univariate analysis showed that the occurrence of hypotension after endotracheal intubation in emergency trauma patients was mainly related to age,mean arterial pressure(MAP)before endotracheal intubation,arterial oxygen saturation,acute physiological and chronic health score(APACHEⅡ)and shock index(SI)(P<0.05).Compared with non-hypotensive group,the expression levels of heart rate(HR),diastolic blood pressure(DBP),systolic blood pressure(SBP)and FTc in hypotensive group were increased(P<0.05).Hypotension after endotracheal intubation in emergency trauma patients was used as the dependent variable,and variables with P<0.05 in univariate analysis were selected as independent variables.The results of multivariate Logistic regression analysis showed that,age,arterial oxygen saturation,MAP before intubation and APACHEⅡscore were the main risk factors for hypotension after endotracheal intubation in emergency trauma patients(P<0.05).Carotid FTc had high clinical value in predicting hypotension after tracheal intubation in emergency trauma patients(P=0.001).Conclusion To observe the changes of hemodynamic indexes after endotracheal intubation in emergency trauma patients,carotid FTc can effectively improve the value of predicting hypotension after endotracheal intubation in emergency trauma patients.
作者
柳东之
邵弘毅
罗宇
文琪
蒋守银
LIU Dongzhi;SHAO Hongyi;LUO Yu(Shaoxing Central Hospital,Zhejiang 312030,China)
出处
《浙江创伤外科》
2024年第1期10-13,共4页
Zhejiang Journal of Traumatic Surgery
基金
浙江省医药卫生科技计划项目(2023XY057)。
关键词
颈动脉校正血流时间
急诊创伤
气管插管
低血压
Carotid corrected flow time
Emergency trauma
Tracheal intubation
Hypotension
