在非选择性剖腹产中进行脊髓麻醉后,术前冲击指数和低血压之间的关联:一项前性队列研究
Shirish Silwal1, Asish Subedi2, Balkrishna Bhattarai3
1Department of Anesthesia, Bharatpur Hospital, Bharatpur, Nepal.
BMC anesthesiology
|October 24, 2024
概括
基线冲击指数 (SI) 0.9或更高与非选择性剖腹产的妇女的低血压有关. 虽然SI单独具有有限的预测能力,但当与其他风险因素相结合时,它可以改善预测.
科学领域:
- 产科麻醉 产科麻醉 产科麻醉
- 心血管生理学心血管生理学
- 手术风险评估手术风险评估
背景情况:
- 冲击指数 (SI),计算为心率除以缩血压,是分娩学中不良结果的公认指标.
- 一个SI ≥0.9的值与增加的孕产妇风险有关.
研究的目的:
- 调查基线冲击指数 (SI) 与脊柱后低血压的发生之间的关联.
- 评估SI在非选择性剖腹产中脊柱麻醉后的低血压的预测能力.
主要方法:
- 一项前性观察性研究招募了在脊髓麻醉下接受非选择性剖腹产的孕产妇.
- 使用单变量和多变量逻辑回归分析来评估基线SI (分类为<0.9和≥0.9) 和低血压之间的关联.
- 用接收器操作特征 (ROC) 曲线来评估SI在预测低血压方面的诊断能力.
主要成果:
- 在分析的335名分娩者中,46.27%经历了脊柱后低血压,34.03%报告了分娩后低血压.
- 术前SI≥0.9与脊柱后低血压 (AOR,2.77) 和分娩后低血压 (AOR,4.34) 显著相关.
- 仅仅SI的ROC曲线下的面积很小 (交付前为0.53,交付后为0.56),但结合SI的多变量模型显示出更好的预测 (分别为0.623和0.679).
结论:
- 基线SI值为0.9或更高,是进行非选择性剖腹产的分娩妇女中脊柱后和分娩后低血压的重要预测指标.
- 虽然单独的SI具有有限的预测价值,但将其集成到多变量模型中可以提高该人群中低血压的预测.
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