在非心脏手术期间术前低血压的发生率和危险因素:回顾性队列研究
Zhilin Sun1, Kaiyu Wang2, Peining Ji1
1Department of Anesthesiology, Liangxiang Hospital, Beijing, China.
Medicine
|January 10, 2026
概括
术后低血压 (POH) 在非心脏手术中很常见,增加了急性损伤 (AKI) 和心肌损伤 (MINS) 的风险. 关键预测因素包括更高的ASA类,较低的基线MAP和紧急手术,而神经轴麻醉可能会提供保护.
科学领域:
- 麻醉学和外科手术期间的医学.
- 心血管和脏医学 心血管和脏医学
- 手术结果研究研究.
背景情况:
- 术后低血压 (POH) 经常发生在非心脏手术期间.
- POH与急性损伤 (AKI) 和非心脏手术 (MINS) 后心肌损伤等不良结果有关.
- 之前的研究缺乏对POH的一致的定义和风险模型.
研究的目的:
- 在接受非心脏手术的大群中确定POH的发病率.
- 确定POH的独立风险因素.
- 评估不同平均动脉压 (MAP) 值的发现的稳定性.
主要方法:
- 对3000名接受非心脏手术的成年患者进行了回顾性队列研究.
- POH定义为手术期间的MAP<65 mmHg,持续时间≥5分钟.
- 用于识别预测因素的多变量逻辑回归;用MAP值<60和<70mmHg进行的灵敏度分析.
主要成果:
- POH发生率为25.8%,因麻醉技术和手术风险而异.
- 独立预测因素包括较高的ASA类,较低的基线MAP,高/中等的手术风险,紧急手术,ACEI/ARB延续,更长的持续时间和血管活性使用.
- 神经轴麻醉具有保护性 (OR 0.71). POH与AKI,MINS和ICU入院有很强的关联.
结论:
- POH是非心脏手术的普遍并发症,具有显著的不良后果.
- 确定的风险因素为干预和风险分层提供了目标.
- 个性化血液动力学管理对于减轻POH及其相关并发症至关重要.
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