医学物联网技术在麻醉前血压管理中的应用

Application of medical internet of things in management of blood pressure before anesthesia

目的总结医学物联网技术应用于手术患者术前3d内血压管理的临床效果。方法随机选取择期手术患者30例,术前3d发放医学物联网血压计,测量术前3、2、1d和术前1h的血压和心率,并通过物联网将数据发送至麻醉医生的手机,实施即时血压管理。结果 30例中,仅有1例术前3d的静息血压超过140/90mmHg。所有患者术前1h的收缩压、舒张压和心率高于术前3、2和1d静息状态的测量值(P<0.05);其中,有2例患者术前1h收缩压≥180mmHg。考虑他们术前3d内的静息血压都在正常范围,所以麻醉医生认为是焦虑紧张引起的心理应激反应;经与手术者讨论,决定不停手术,加强术中监测,顺利完成手术。结论择期手术患者焦虑引起的应激反应主要发生在术前12h内。临床上,入手术室后的收缩压≥180mmHg作为暂停手术的标准值待商议。

Objective To summarize the application of the medical internet of things in the management of blood pressure within three days before surgery.Methods The networking sphygmomanometer was send to 30 patients scheduled for surgeries three days before operation.The data of blood pressure and heart rate measured by patient himself on the 3 rd,2 nd,and 1 st day before operation were transferred by mobile phone to the anesthetist who was responsible to him.Results Of30 patients,only one patient had the resting blood pressures more than 140/90 mmHg in 3 days before operation.The systolic blood pressure,diastolic blood pressure and heart rate in 30 cases were all higher one hour before operation than those on the 3 rd,2 nd,and 1 st day before surgery（P〈0.05）.Of them,two cases had the resting systolic blood pressures more than 180 mmHg one hour before operation.Their surgeries were performed at scheduled time after considering that their blood pressures were all in normal limits in three days before surgery and the hypertension was a stess response to preoperative anxiety.The surgeries of two cases were performed with stable circulation under careful monitoring and management.Conclusion The stress response to preoperative anxiety occurs mainly in 12 hours before operation.It is worthy of discussing to take systolic blood pressure≥180 mmHg as a standard for suspension of surgery after the patients entered in operation room.