国际麻醉学与复苏杂志   2016, Issue (4): 0-0
    
全身麻醉中连续无创动脉血压监测与有创动脉血压 监测的比较
仇焕容, 魏威, 田鸣1()
1.首都医科大学附属北京友谊医院麻醉科
Comparative study of blood pressure monitoring between TL-300 continuous non-invasive arterial pressure measurement and invasive radial artery pressure measurement for patients under general anesthesia
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摘要:

目的 评价麻醉期间TL-300系统测得的连续无创血压(continuous non-invasive arterial pressure, CNAP)和有创血压(invasive arterial pressure, IAP)监测的一致性和安全性。 方法 择期全身麻醉手术患者72例,麻醉诱导前将动脉导管置入非优势手的桡动脉内行IAP监测,另一侧手臂连接TL-300系统行CNAP监测,记录IAP及相应时间点CNAP,以及相关的并发症。 结果 CNAP与IAP所测SBP、DBP和MAP偏倚分别为(-0.6±7.0)、(-7.8±9.8)和(-5.8±6.2) mmHg(1 mmHg=0.133 kPa),一致性界限分别为-14.6~13.4 mmHg、-27.4~11.8 mmHg、-18.2~6.6 mmHg,在其相应的一致性界限范围内所占比值分别为95.2%、96.1%和94.9%。两种BP监测方法的SBP、DBP和MAP的相关系数r分别为0.927、0.711和0.903(P<0.01)。均未发生肢体缺血、坏死、感觉异常。 结论 TL-300 CNAP和IAP比较,有较高的相关性和一致性,提供无创实时连续、准确的BP监测,可安全用于全身麻醉手术患者。

关键词: 连续无创动脉血压; 有创动脉血压; 麻醉,全身
Abstract:

Objective To compare the difference between TL-300 continuous non-invasive arterial pressure (CNAP) and invasive arterial pressure (IAP) monitoring. Methods Seventy and two patients undergoing surgery under general anesthesia were enrolled at our study. Invasive radial pressure monitoring was established in the non-dominant hand. CNAP monitoring (TL-300) used a pressure sensor directly over the radial artery at the wrist before induction of anesthesia. The Bland-Altman plot was used to determine the bias of blood pressure measurements between CNAP with TL-300 and IAP during general anesthesia maintenance. Results We obtained 433 valid pressure readings from 72 patients. For SBP, the bias (SD of bias) was (-0.6±7.0) mmHg (limits of agreement: -14.6-13.4 mmHg, 1 mmHg=0.133 kPa). For DBP, the bias (SD of bias) was (-7.8±9.8) mmHg (limits of agreement: -27.4 -11.8 mmHg). For MAP, the bias (SD of bias) was (-5.8±6.2) mmHg (limits of agreement: -18.2-6.6 mmHg). The percentage within limits of agreement was 95.2%, 96.1%, 94.9%, respectively. Pearson correlation analysis was made for SBP, DBP, and MAP. Invasive arterial pressures measurement were closely correlated with continuous non-invasive arterial pressures measurement. The correlation coefficient was 0.927, 0.711, 0.903, respectively (P<0.01). Conclusions High correlation and good agreement of blood pressure measurement exists between CNAP with TL-300 and IAP monitoring during general anesthesia.

Key words: Continuous non?蛳invasive arterial pressure; Invasive arterial pressure; Anesthesia, general