胸腔镜下肺叶切除术患者术中发生低血压的相关影响因素分析

Analysis of Related Influencing Factors of Intraoperative Hypotension in Patients Undergoing Video-assisted Thoracic Surgery

目的:探讨胸腔镜下肺叶切除术(VATS)患者术中发生低血压(IOH)的影响因素。方法:选取2021年1月—2022年6月在中国融通医疗健康集团莆田九十五医院行VATS术患者83例,统计所有患者术中IOH发生情况,根据结果分为发生组(n=20)与未发生组(n=63),设计基线资料调查表,详细统计两组的基线资料并比较,分析行VATS患者术中发生IOH的影响因素。结果:83例行VATS患者术中发生IOH的有20例,占比24.10%(20/83)。两组年龄、性别、体重指数(BMI)、美国麻醉医师协会(ASA)分级、合并糖尿病、手术时间、白细胞计数(WBC)、血小板计数(PLT)水平比较,差异无统计学意义(P>0.05);发生组合并高血压、术中低体温发生率及术中出血量高于未发生组,白蛋白(ALB)水平低于未发生组,差异有统计学意义(P<0.05)。logistic回归分析结果显示,合并高血压、术中出血量多、术中低体温均是行VATS术患者发生IOH的危险因素,高ALB水平是行VATS术患者发生IOH的保护因素(P<0.05)。结论:行VATS术患者发生IOH风险较高,可能与合并高血压、术中低体温、术中出血量及ALB水平有关。

Objective:To investigate the influencing factors of intraoperative hypotension(IOH)in patients undergoing videoassisted thoracic surgery(VATS).Method:A total of 83 patients who underwent VATS in China Rongtong Medical Health Group Putian 95 Hospital from January 2021 to June 2022 were selected.The intraoperative IOH occurrence of all patients was statistically analyzed,and the patients were divided into occurrence group(n=20)and non-occurrence group(n=63)according to the results.The baseline data questionnaire was designed,and the baseline data of the two groups were collected in detail and compared.The influencing factors of IOH in patients undergoing VATS were analyzed.Result:IOH occurred in 20 of 83 patients undergoing VATS,accounting for 24.10%(20/83).There were no significant differences in age,sex,body mass index(BMI),American Society of Anesthesiologists(ASA)grade,combined with diabetes,operation time,white blood cell count(WBC),platelet count(PLT)levels between the two groups(P>0.05).The incidence of combined with hypertension,intraoperative hypothermia and intraoperative blood loss were higher than those in the non-occurrence group,and the level of albumin(ALB)was lower than that in the non-occurrence group,the differences were statistically significant(P<0.05).logistic regression analysis showed that combined with hypertension,more intraoperative blood loss and intraoperative hypothermia were the risks factors for IOH in VATS patients,and high ALB level was the protective factor for IOH in VATS patients(P<0.05).Conclusion:Patients undergoing VATS have a higher risk of developing IOH,which may be related to combined with hypertension,intraoperative hypothermia,intraoperative bleeding loss,and ALB levels.