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纠正的动脉流量时间的变化可以预测在接受剖腹产的患者中脊髓麻醉诱导的低血压:一项观察性研究
Takashi Juri1, Koichi Suehiro2, Shinta Yasuda1
1Department of Anesthesiology, Osaka Metropolitan University Graduate School of Medicine, 1-5-7 Asahimachi, Abenoku, Osaka, 545-8586, Japan.
Journal of anesthesia
|January 3, 2024
概括
在Trendelenburg姿势期间纠正的流量时间的变化可以预测剖腹产后脊髓麻醉后的低血压. 这一发现有助于在这种常见的产科手术期间管理患者的安全.
科学领域:
- 麻醉学 麻醉学
- 产科 产科 产科 产科 产科
- 心血管生理学心血管生理学
背景情况:
- 脊柱麻醉是剖腹产的标准,但存在低血压的风险.
- 预测和预防低血压对于母亲和胎儿的健康至关重要.
研究的目的:
- 评估由Trendelenburg位置诱导的校正动脉流量时间 (ΔFTc) 的变化是否可以预测剖腹产后脊髓麻醉后的低血压.
- 为了比较麻醉前调整流量时间 (FTc-1),麻醉后调整流量时间 (FTc-2) 和 ΔFTc. 的预测能力.
主要方法:
- 在脊髓麻醉下进行选择性剖腹产的患者的潜在招募.
- 在麻醉之前,测量卧底 (FTc-1) 和Trendelenburg (FTc-2) 位置的校正流量时间.
- 计算校正流量时间 (ΔFTc) 的百分比变化,并使用接收器运行特性 (ROC) 曲线进行分析.
主要成果:
- 在40名患者中,有65%患有脊髓麻醉引起的低血压.
- 与FTc-1 (AUC = 0.591) 和FTc-2 (AUC = 0.742) 相比,ΔFTc表现出最高的预测能力 (曲线下的面积[AUC] = 0.882,P < 0.001).
- 6.4%的ΔFTc值显示了80.8%的灵敏度和85.7%的特异性来预测低血压.
结论:
- 由Trendelenburg位置诱导的校正动脉流量时间的变化是剖腹产中脊柱麻醉诱导的低血压的可靠预测指标.
- ΔFTc为低血压的风险评估和主动管理提供了一种有价值的非侵入性方法.
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