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术中血压管理对心血管高风险患者行腹腔镜胃肠肿瘤手术苏醒后拔管时间的影响
Effect of intraoperative blood pressure management on extubation time after laparoscopic gastrointestinal tumor surgery in patients with high cardiovascular risk
- 陆军军医大学学报 2023年45卷第5期 页码：456-461
- 作者机构：
400037 重庆，陆军军医大学(第三军医大学)第二附属医院麻醉科
- 作者简介：
[李洪，E-mail: lh78553@163.comLI Hong, E-mail: lh78553@163.com
- 基金信息：
DOI：10.16016/j.2097-0927.202211146
中图分类号： R443.5;R614;R735收稿：2022-11-19，
修回：2023-01-07，
纸质出版：2023-03-15
- 稿件说明：
移动端阅览
陈群, 龙宗泓, 白福海, 等. 术中血压管理对心血管高风险患者行腹腔镜胃肠肿瘤手术苏醒后拔管时间的影响[J]. 陆军军医大学学报, 2023,45(5):456-461.
Qun CHEN, Zonghong LONG, Fuhai BAI, et al. Effect of intraoperative blood pressure management on extubation time after laparoscopic gastrointestinal tumor surgery in patients with high cardiovascular risk[J]. Journal of Army Medical University, 2023, 45(5): 456-461.
陈群, 龙宗泓, 白福海, 等. 术中血压管理对心血管高风险患者行腹腔镜胃肠肿瘤手术苏醒后拔管时间的影响[J]. 陆军军医大学学报, 2023,45(5):456-461. DOI： 10.16016/j.2097-0927.202211146.
Qun CHEN, Zonghong LONG, Fuhai BAI, et al. Effect of intraoperative blood pressure management on extubation time after laparoscopic gastrointestinal tumor surgery in patients with high cardiovascular risk[J]. Journal of Army Medical University, 2023, 45(5): 456-461. DOI： 10.16016/j.2097-0927.202211146.
摘要
目的
2
探讨术中血压管理对心血管高风险患者行腹腔镜胃肠肿瘤手术苏醒后拔管时间的影响。
方法
2
从我院病历系统中收集2020年7月至2021年11月进行腹腔镜胃肠肿瘤手术且符合入选标准的病例共计198例，根据术中血压管理情况，分为常规血压组(术中平均动脉压≥65 mmHg)和强化血压组(术中平均动脉压≥80 mmHg)
记录2组病例术后拔管时间、Steward苏醒评分、睡眠、恶心呕吐、声嘶、疼痛等情况。作为敏感性分析
分别使用多元线性回归、逆概率处理加权(inverse probability of treatment weighting
IPTW)和重叠加权法(overlap weighting)平衡混杂因素影响后，分析不同血压水平的主要观察指标的差异，将标准均数差(standard Mean difference
SMD)作为组间均衡性的评价指标，倾向性匹配后做线性回归，判断术中血压管理与术后拔管时间的关系。
结果
2
强化血压组术后拔管时间显著短于常规血压组[(42.56±25.88)
vs
(79.15±39.45) min，
P
＜0.001
]
。
结论
2
术中强化血压管理策略能缩短心血管高风险患者行腹腔镜胃肠肿瘤手术苏醒后拔管时间。
Abstract
Objective
2
To explore the effect of intraoperative blood pressure management on the time of extubation after awakening from laparoscopic gastrointestinal tumor surgery in patients with high cardiovascular risk.
Methods
2
Clinical data of 198 patients who underwent laparoscopic gastrointestinal tumor surgery from July 2020 to November 2021 and met the inclusion criteria were collected from the medical record system of our hospital. According to the intraoperative blood pressure management
they were divided into routine blood pressure group (intraoperative mean arterial pressure ≥65 mmHg) and intensive blood pressure group (intraoperative mean arterial pressure ≥80 mmHg). Their extubation time
Steward recovery score
sleep
incidence of nausea and vomiting
hoarseness
pain and other conditions were recorded. For sensitivity analysis
multiple linear regression
inverse probability of treatment weighting (IPTW) and overlap weighting were respectively used to balance the influence of confounding factors
and the differences of main observation indexes of different blood pressure levels were analyzed. Standard mean difference (SMD) was used as
the evaluation index of the equilibrium between groups. Linear regression was performed after propensity matching. To judge the relationship between intraoperative blood pressure management and postoperative extubation time
P
<
0.05 was considered statistically significant.
Results
2
The extubation time was significantly shorter in the intensive blood pressure group than the routine blood pressure group (42.56±25.88
vs
79.15±39.45 min
P
<
0.001).
Conclusion
2
Intraoperative intensive blood pressure management strategy can shorten the postoperative extubation time after laparoscopic gastrointestinal tumor surgery.
关键词
Keywords
references
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