连续无创血压监测在全麻手术病人中的应用观察

Application of continuous noninvasive blood pressure monitoring in general anesthesia

目的分析连续无创血压(CNAP)监测在全麻手术病人中的应用效果,为临床应用提供参考依据。方法选取2015年6月至2016年1月我院收治的30例全麻手术病人作为研究对象,ASA分级为Ⅰ~Ⅲ级,均行全身麻醉,于麻醉诱导之前分别行CNAP监测和动脉连续有创血压(IAP)监测,定时记录舒张压、收缩压和平均动脉压,并分析IAP与CNAP监测结果的一致性及相关性。结果共记录1147对数据,剔除39对数据,共有1108对数据纳入统计分析,CNAP和IAP监测所测的平均动脉压、舒张压与收缩压的差值分别是(2.62±6.77)、(3.20±7.12)、(-0.087±9.58)mm Hg,一致性界限分别为(-10.91~13.12)、(-11.01~17.42)和(-19.25~19.80)。Pearson相关性分析结果显示,CNAP和IAP监测所测的平均动脉压、舒张压与收缩压均呈显著正相关(r=0.856、0.778、0.724,P<0.05);CNAP监测无皮肤渗血、皮下血肿等相关并发症发生。结论在全麻手术病人中,CNAP监测可提供准确、实时的血压监测,与IAP监测有较高的一致性与相关性,且无肢体缺血、皮肤坏死等并发症发生,可安全有效地用于全麻手术病人的血压监测。

Objective To investigate the application effect of continuous non-invasive arterial pressure（ CNAP） monitoring in general anesthesia,and to provide reference for clinical application.Methods Thirty patients receiving general anesthesia in our hospital from June 2015 to January 2016 were selected as study subjects. All patients were given the general anesthesia. CNAP monitoring and arterial continuous invasive blood pressure（ IAP） monitoring were performed before anesthesia induction.The diastolic blood pressure,systolic blood pressure and mean arterial pressure were recorded,and the consistency and correlation of IAP and CNAP monitoring results were analyzed. Results A total of1108 pairs of data were included in this study. The difference between IBP and NIBP were（ 2. 62 ±6. 77）,（ 3. 20± 7. 12）,（-0. 087 ± 9. 58） mm Hg in mean arterial pressure,diastolic arterial pressure and systolic arterial pressure,respectively. The consistency limits were（-10. 91-13. 12）,（-11. 01-17. 42）, and（-19. 25-19. 80）. Pearson correlation analysis showed that CNAP and IAP were significantly positively correlated in mean arterial pressure,diastolic blood pressure and systolic blood pressure（ r = 0. 856,0. 778,0. 724,P〈0. 05）. There was no skin oozing blood,subcutaneous hematoma and other related complications. Conclusions In general anesthesia,CNAP monitoring can provide accurate,real-time monitoring of blood pressure,and has a higher correlation with IAP monitoring,with no occurrence of limb ischemia,necrosis of skin.