术前患者的风险因素为手术内低血压:一个系统的审查和元分析
Nils Daum1,2, Daniel Bill1, Moritz Thiele2
1Department of Anesthesiology and Intensive Care Medicine (CCM/CVK), Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt, Universität zu Berlin, Berlin, Germany.
Frontiers in cardiovascular medicine
|December 22, 2025
概括
内手术性低血压 (IOH) 的危险因素因定义不一致而有所不同. 老年,女性性别,糖尿病,高血压和某些药物增加IOH风险,需要标准化标准来更好地照顾患者.
科学领域:
- 麻醉学 麻醉学
- 在外科手术期间的医学.
- 关键的护理关键的护理
背景情况:
- 术内低血压 (IOH) 是术后器官功能障碍的危险因素.
- 缺乏一个独特的IOH定义阻碍了对术前患者特征影响的理解.
- 本审查审查了IOH定义的变化,并确定了相关的手术前风险因素.
研究的目的:
- 分析术内低血压 (IOH) 的定义中的异质性.
- 确定术前患者特征,这些特征是IOH的独立预测因素.
- 为改进外科手术期间管理提供标准化标准.
主要方法:
- 在2024年3月2日之前进行了系统的文献搜索.
- 包括报告IOH和心脏和非心脏手术前手术风险因素的研究.
- 使用随机效应模型进行元分析,以聚合几率比率 (ORs).
主要成果:
- 78项研究符合纳入标准,由于IOH定义不同,具有很高的异质性.
- 年龄较大 (OR 1.03),女性性别 (OR 1.16),糖尿病 (OR 1.18) 和动脉高血压 (OR 1.56) 与IOH风险增加有关.
- 使用ACE抑制剂 (OR 1.63),ARB使用 (OR 1.38) 和新出现的手术 (OR 1.25) 也增加了IOH发生率;ASA-II与ASA-III (OR 0.80) 相比,与较低的风险有关.
结论:
- 在不同研究中,IOH定义存在显著的变化.
- 几种手术前患者的特征独立地与IOH风险相关.
- 为了提高可比性和个性化的术后护理,需要标准化的IOH标准.
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