心率变异率预测高血压患者椎管内麻醉低血压发生的准确性.pdfVIP

《中国医学创新》第 12 卷 第 4 期（总第 322 期）2015 年 2月　　经验交流 Jingyanjiaoliu 心率变异率预测高血压患者椎管内麻醉 低血压发生的准确性 杨春艳① 【摘要】　目的： 　　 高血压患者行椎管内麻醉后出现低血压是常见的现象，本研究探讨高血压患者行椎管内麻 方法： 醉后心率变异率是否能够预测低血压的发生。 41 例高血压患者行椎管内麻醉纳入研究，记录心脏变异率 的五个时间点，输入液体前，输入液体后 5、15、30 min。液体负荷 5 mL/kg 乳酸钠林格氏液，基线的变异率， 结果： 椎管内麻醉后低血压与最高血压的比值，通过计算曲线下面积获得。 LF/HF 椎管内麻醉后心率无明显差 异，LF/HF 预测中等低血压的曲线下面积为 0.685（P=0.074），严重低血压为 0.579（P=0.560）。结论：心率变 异率不是椎管内麻醉交感神经阻滞后预测血压变化的可靠指标。 【关键词】 　　 　高血压；　椎管内麻醉；　低血压 　　The Accuracy of Heart Rate Variability as A Predictor of Hypotension after Spina Anesthesia in Hypertensive Patients/YANG Chun-yan.//Medical Innovation of China，2015，12（04）：123-125 　　【Abstract】　Objective：To evaluate the accuracy of using heart rate variability parameters to predict the occurrence of hypotension.Hypotension is a common phenomenon in hypertensive patients with spinal anesthesia.Method：41 patients undergoing spinal anesthesia were included， heart rate variability was recorded at five different time points such as before fluid loading， after fluid loading as well as 5，15 and 30 min after spinal anesthesia.Fluid loading was performed using 5 mL/kg of a crystalloid solution.Baseline multation power and low to high frequency ratio （LF/HF） in predicting hypotension after spinal anesthesia were analyzed by calculating the area under curves （AUC）.Result：LF/HF ratios and total powers did not significantly change after spinal anesthesia.AUCs of LF/HF ratio for predicting moderate hypotension was 0.685 （ =0.074）， severe hypotension was 0.579 （ =0.560） .Conclusion：Heart rate variability is not a reliable predictor of P P hypotension after spinal block in hypertensive patients. 　　【Key words】　Hypertension；　Spinal anesthesia；　Hypotension ’ ’ 　　First-author s address：The Pe