颈动脉校正血流时间对剖宫产腰-硬联合麻醉后低血压的预测价值

Predictive value of carotid artery correction flow time on hypotension after combined spinal-epidural anesthesia in cesarean parturient women

目的:探讨颈动脉校正血流时间(FTc)对剖宫产产妇腰-硬联合麻醉(CSEA)后低血压的预测价值。方法:择期行剖宫产术的足月单胎产妇122例,麻醉前超声测量并计算颈动脉FTc,记录麻醉前、麻醉10 min后的心率(HR)、收缩压(SBP)、舒张压(DBP)。麻醉10 min内SBP下降30%或下降至80 mmHg(1 mmHg=0.133 kPa)以下为低血压。绘制麻醉前FTc预测麻醉后低血压的ROC曲线。结果:共有48例产妇发生低血压。与无低血压组(74例)相比,低血压组产妇ΔSBP、ΔDBP、ΔHR、颈动脉FTc升高(P<0.05)。麻醉前颈动脉FTc预测麻醉后低血压的ROC曲线的AUC(95%CI)为0.926(0.864~0.965),诊断界值为327.15 ms,敏感度为0.896,特异度为0.797。结论:超声测量颈动脉FTc可用于剖宫产CSEA后低血压的预测。

Aim:To explore the value of corrected flow time(FTc)of carotid artery for predicting hypotension after cesarean section with combined spinal-epidural anesthesia(CSEA).Methods:A total of 122 full-term singleton parturients who underwent elective cesarean section were adopted CSEA.The carotid artery FTc was measured and calculated by ultrasound before anesthesia.The SBP,DBP,HR before and after anesthesia were recorded,and SBP decreasing by 30%or below 80 mmHg(1 mmHg=0.133 kPa)after anesthesia was defined as hypotension.The ROC curve of carotid artery FTc predicting hypotension after anesthesia was drawn.Results:Hypotension occurred in 48 parturients.Compared with the other 74 parturients without hypotension,theΔSBP,ΔDBP,ΔHR and the carotid artery FTc of the hypotension group significantly increased(P<0.05).The AUC(95%CI)of ROC curve of carotid artery FTc predicting hypotension after anesthesia was 0.926(0.864-0.965),the diagnostic cut-off value was 327.15 ms,the sensitivity was 0.896,and the specificity was 0.797.Conclusion:Ultrasound measurement of carotid artery FTc can predict the occurrence of hypotension after CSEA.