老年患者手术前巴罗反射灵敏度与诱导后低血压之间的关联:一个前性队列研究
Quexuan Cui1, Lu Che, Jiawen Yu
1Department of Anesthesiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China.
老年患者的诱导后低血压 (PIH) 与降低巴罗反射灵敏度 (BRS) 有关. 较低的BRS表明PIH的风险更高,突出显示BRS是自主功能的关键指标.
科学领域:
- 麻醉学 麻醉学
- 心血管生理学心血管生理学
- 老年医学 老年医学
背景情况:
- 诱导后低血压 (PIH) 是老年手术患者的常见和严重并发症.
- 心血管自主功能,通过巴罗反射灵敏度 (BRS) 评估,在血压调节中起着至关重要的作用.
- 降低BRS被怀疑会导致手术内血压不稳定.
研究的目的:
- 研究老年患者中巴罗反射敏感性受损 (BRS) 和诱导后低血压 (PIH) 发生率之间的关联.
- 评估术后BRS测量的实用性,以评估与PIH相关的自主功能.
主要方法:
- 65岁以上的患者在全身麻醉下接受选择性非心脏手术的前景招募.
- 持续的非侵入性动脉压 (CNAP) 监测,以计算巴罗反射灵敏度 (BRS) 和巴罗反射效率指数 (BEI).
- 主要结局是PIH的发生率;次要结局包括早期手术内低血压和术后并发症.
主要成果:
- 在57.5%的老年人群中发生PIH.
- 与没有PIH的患者相比,PIH患者的BRS和BEI值明显较低 (p<0.001).
- 多变量分析证实BRS是PIH的显著预测因子 (p<0.001),BRS+的AUC为0.747.
结论:
- 降低巴罗反射灵敏度与老年患者的诱导后低血压显著相关.
- 使用CNAP设备进行外科手术期间的BRS测量是评估这种人群中自主神经系统功能的有效方法.
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