全麻手术患者围术期下肢有创血压与无创血压的相关性分析

Comparison of non-invasive and invasive blood pressure in lower limbs

目的比较全麻手术患者下肢踝部无创血压与同侧足背动脉有创血压的差异。方法选择神经外科择期手术的患者24例,ASAⅠ~Ⅲ级,均行静脉全身麻醉。术中同时监测下肢踝部无创袖带血压和同侧足背动脉置管有创血压。采用Bland-Altman法分析两种血压测量方法的一致性。结果下肢无创SBP、DBP均明显高于有创SBP、DBP（P〈0.05）。有创血压值与无创血压值之间具有较好的相关性,SBP与DBP的Pearson相关系数分别为0.833和0.757（P〈0.01）。有创SBP与无创SBP的平均偏差-3.8mm Hg,一致性界限为-24.0~16.4mm Hg,有创DBP与无创DBP的平均偏差-5.4mm Hg,一致性界限为-18.1~7.4mm Hg。结论围手术期监测患者下肢血压时应该考虑到无创袖带和动脉内置管两种测压方法所得血压值存在一定的差异。

Objective To compare the difference between non-invasive and invasive blood pres- sure in lower limbs. Methods Simultaneous measurements of non-invasive and invasive blood pres sure made during operation in neurosurgery patients under general anesthesia were recorded. Non-in- vasive blood pressure was measured in the posterior tibial artery and invasive blood pressure was measured in the dorsalis pedis artery. Bland-Altman plots were created to assess agreement between the two measurement methods. Results Non-invasive SBP and DBP were significantly higher than in- vasive SBP and DBP in lower limbs, respectively. There was a good correlation between non-invasive and invasive blood pressure as measured with a cuff and dorsalis pedis arterial cannula in lower limbs （SBP r= 0. 833, DBP r=0. 757, P〈0.01）. The mean differences and limit of agreements between the two methods were --3.8 mm Hg（--24. 0 to 16.4 mm Hg）for SBP and --5.4 mm Hg（-18.1 to 7.4 mm Hg） for DBP, respectively. Conclusion These results suggest that anesthesiologists should con- sider the difference between non-invasive and invasive blood pressure when monitoring vital signs in intraoperative patients.