术后低血压与术后恶心和吐之间的关联:一个回顾性队列研究
Sebastian Goss1, Jan Jedlicka1, Elisabeth Strinitz1
1Department of Anaesthesiology, LMU University Hospital, LMU Munich, Munich, Germany.
Current medical research and opinion
|July 1, 2024
概括
术后低血压,定义为70mmHg以下的平均动脉压 (MAP),显著增加了术后恶心和吐 (PONV) 的风险. 较低的MAP水平与手术患者中PONV发病率较高相关.
科学领域:
- 麻醉学和外科手术期间的医学.
- 临床研究 临床研究
- 患者安全 患者安全
背景情况:
- 手术后恶心和吐 (PONV) 影响高达30%的患者,病理生理学不明.
- 低血压和心脏输出量减少被怀疑是PONV的贡献者.
- 术内低血压和PONV之间的联系需要进一步调查.
研究的目的:
- 为了研究这种假设,即手术内低血压会影响PONV的发病率.
- 量化不同水平的手术内低血压和PONV之间的关联.
- 分析平均动脉压 (MAP) 对早期PONV结局的影响.
主要方法:
- 追溯性,大型,单中心的队列研究.
- 包括在全身麻醉下进行手术的患者 (2018-2019).
- 根据最低MAP (H50: <50mmHg,H60: <60mmHg,H70: <70mmHg,H0:没有MAP <70mmHg) 和倾向性-分数匹配,分组进行分类.
主要成果:
- 在18674名患者中,整体PONV发病率为11%.
- 患有低血压的患者与对照组相比,PONV发病率显著增加 (H0).
- 风险比率表明了较低的MAP和较高的PONV发病率之间的剂量依赖关系 (例如,H0与H50:RR 1.285,p<0.001).
结论:
- 在手术内低血压和早期PONV之间存在显著的关联.
- 更严重的手术内低血压表明对PONV发病率的影响更为明显.
- 管理手术内MAP可能对减轻PONV风险至关重要.
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