肾移植患者发生全麻苏醒期高血压危象的影响因素分析

Analysis of influencing factors of hypertensive crisis in renal transplantation patients during recovery period under general anesthesia

目的探讨肾移植患者发生全麻苏醒期高血压危象的影响因素。方法回顾性分析2019年9月—2021年9月期间吉林大学第一医院进行的98例急诊同种异体肾移植手术的临床资料。根据麻醉苏醒期的血压分为高血压危象组(49例)和血压稳定组(49例),对比两组的临床资料并分析肾移植患者发生全麻苏醒期高血压危象的影响因素。结果高血压危象组与血压稳定组相比,前者平均年龄较大、BMI值较高、受体存在原发性高血压的比例较大、高血压脑出血供肾的比例较大、T1和T2时的收缩压较高(P<0.05)。应用Logistic回归分析,结果表明排除混杂因素,年龄(OR 1.073,95%CI 1.018-1.132)和存在原发性高血压(OR 0.286,95%CI 0.089-0.919)是影响因素。结论受体的年龄和是否有原发性高血压是肾移植患者发生全麻苏醒期高血压危象的独立影响因素,且年龄越大、存在原发性高血压,发生全麻苏醒期高血压危象的可能性越大。

Objective To investigate the clinical risk factors of hypertensive crisis during recovery period of general anesthesia in renal transplantation patients.Methods Analyzing retrospectively 88 emergency renal allograft operations performed in the First Hospital of Jilin University from September 2019 to September 2021.According to the blood pressure during anesthesia recovery period,the patients were divided into hypertensive crisis group(n=49)and stable blood pressure group(n=49),the clinical data of the two groups were compared and the influencing factors of hypertensive crisis during recovery period of general anesthesia in renal transplantation patients were analyzed.Results Hypertensive crisis group compared with stable blood pressure group,the former had an older average age,a higher BMI,a larger proportion of receptors with essential hypertension,a larger proportion of hypertensive cerebral hemorrhage supplying kidney and a higher systolic blood pressure at T1 and T2(P<0.05).Logistic regression analysis showed that excluding other confounding factors,age(or 1.073,95%CI 1.018-1.132)and presence of essential hypertension(or 0.286,95%CI 0.089-0.919)are contributing factors.Conclusion age and presence of essential hypertension are independent influencing factors of hypertensive crisis in renal transplantation patients during recovery period under general anesthesia,and the older the age and the presence of essential hypertension are the more likely to develop an awakening hypertensive crisis.