脉冲波速的增加作为在接受脊髓麻醉的高血压患者手术内低血压的预测因素
1Department of Anaesthesiology and Reanimation, Faculty of Medicine, Aydin Adnan Menderes University, Aydin, Turkiye.
Journal of the College of Physicians and Surgeons--Pakistan : JCPSP
|December 9, 2024
概括
术前脉冲波速度 (PWV) 可以预测脊柱麻醉相关的低血压 (SARH) 在高血压患者. 较高的PWV表明在脊髓麻醉期间和之后,低血压风险增加.
科学领域:
- 心脏病学 心脏病学
- 麻醉学 麻醉学
- 血管生理学 血管生理学
背景情况:
- 术内低血压是脊髓麻醉的常见并发症.
- 高血压是血液动力学不稳定的已知危险因素.
- 脉冲波速率 (PWV) 是动脉硬性的衡量标准.
研究的目的:
- 确定手术前脉冲波速度 (PWV) 是否可以预测脊髓麻醉相关的低血压 (SARH).
- 为了比较高血压患者的PWV与接受脊髓麻醉的对照组.
- 评估PWV与SARH发生之间的相关性.
主要方法:
- 进行了一项描述性分析研究,对成年患者 (≥30岁,ASA I-II) 进行了选择性下肢手术,在脊髓麻醉下进行.
- 患者被分为高血压 (HT) 组和对照组.
- 动脉硬度使用振荡计器件[Mobil-O-Graph]进行测量,以获得PWV,静脉血压 (SBP) 和透气血压 (DBP). SARH被定义为SBP从基线下降≥20%.
主要成果:
- 与对照组相比,高血压组的PWV显著增加 (p <0.001).
- 在脊髓麻醉期间低血压的发生率在高血压组中较大 (p <0.05).
- 开发SARH的患者在多个时间点后脊椎麻醉时的术前PWV值显著更高 (p ≤ 0.002).
结论:
- 术前PWV是一种潜在的生物标志物,用于预测高血压患者的脊髓麻醉相关的低血压.
- 增加的动脉硬度,如较高的PWV所示,与脊髓麻醉后低血压的风险更高有关.
- 这一发现可能有助于风险分层和管理接受脊髓麻醉的高血压患者.
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