手术前营养不良是高风险手术患者手术内低血压的危险因素:一项倾向性得分匹配的队列研究
Zhengzhen Huang1, Chen Wang1, Meimei Zhu1
1Department of Anesthesiology, Navy Medical Center, Naval Medical University, Shanghai, China.
Perioperative medicine (London, England)
|November 19, 2025
概括
手术前营养不良会增加高风险手术患者的手术内低血压风险. 营养不良的个体经历更多的血液动力学不稳定,强调在手术护理中需要进行营养评估.
科学领域:
- 麻醉学和外科手术期间的医学.
- 手术营养是指手术营养.
- 血液动力学监测 血液动力学监测
背景情况:
- 术内低血压 (IOH) 与高风险手术患者的不良结果有关.
- 手术前营养不良可能会增加对IOH的易感性,但其在多个IOH维度上的影响还未得到充分研究.
- 评估营养不良和IOH之间的关联对于患者安全至关重要.
研究的目的:
- 研究手术前营养不良和手术内低血压 (IOH) 之间的关系.
- 用多个指标评估IOH,包括发生率,持续时间和麻醉时间的比例.
- 确定营养不良是否是IOH在高风险手术环境中的独立风险因素.
主要方法:
- 对1504名接受选择性高风险非心脏手术的成年患者进行了回顾性队列研究.
- 使用全球营养不良领导倡议 (GLIM) 标准评估营养状况.
- 根据发生率,累积持续时间,麻醉时间的比例和使用绝对和相对值的最低平均动脉压 (MAP) 评估IOH;相对IOH时间是主要结果.
主要成果:
- 营养不良患者在相对IOH中的时间比例显著增加 (0.48对0.39,P<0.001).
- 营养不良的个体也经历了更长的IOH持续时间和较低的nadir MAP.
- 营养不良独立地与相对IOH增加相关,经同变量调整 (P < 0.001).
结论:
- 手术前营养不良独立地与更大的手术内血动力学不稳定性有关,特别是当通过相对血压变化来评估时.
- 这些发现强调了在术后风险评估中考虑营养状况的重要性.
- 建议进行进一步的前性研究,以确认这些关联并指导临床实践.
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