2015-2020年加拿大大学健康网络医院接受非心脏手术患者围手术期高血压病因

IF 1.5 Q3 PERIPHERAL VASCULAR DISEASE
S. Mohseni, Sahar Behnam-Roudsari, Mohammad Tarbiat, Pouyan Shaker, Seyedmohammadshahab Shivaie, Mohammad Ali Shafiee
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引用次数: 3

摘要

引言围手术期高血压,定义为手术前后血压升高,是围手术期并发症(包括心血管事件)的已知风险因素。识别每个时期与高血压相关的原因对预防和更好地管理围手术期高血压有很大帮助。目的探讨2015年至2020年在加拿大大学健康网络(UHN)医院接受非心脏手术的患者围手术期(术前、术中和术后)高血压的常见病因。患者和方法我们回顾性分析174例非心脏手术患者围手术期高血压的病历。根据医生在患者病历中的记录,我们评估了围手术期高血压的10个原因的患病率,并分别评估了每个时期的患病率。双向测量方差分析用于确定特定病因患者平均高血压的变化。结果围手术期高血压的常见病因为高血压控制不良(21.8%)、补液过量(19.5%)、血管升压药过量(18.4%)和停药(13.7%),最常见的原因是术前(42.9%)和术中(22.7%)高血压控制不佳,术后(20.1%)液体超负荷。高血压控制不佳表现出收缩压在受试者内的统计学意义和舒张压在受检者间的统计学意义。结论高血压控制不良是非心脏手术患者围手术期高血压最重要的病因。除了高血压控制不佳外,作为一种与患者相关的因素,医源性因素,如过度的血管升压药治疗、积极的补液和降压药物管理不善,也会导致围手术期高血压。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Perioperative Hypertension Etiologies in Patients Undergoing Noncardiac Surgery in University Health Network Hospitals–Canada from 2015–2020
Introduction Perioperative hypertension, defined as increased blood pressure around the surgery, is a known risk factor for perioperative complications, including cardiovascular events. Identifying reasons associated with hypertension in each period is of great help in preventing and better managing perioperative hypertension. Objective The aim of the study was to explore common etiologies of hypertension during the perioperative period (pre, intra, and post-operation) in patients who underwent noncardiac surgeries in University Health Network (UHN) hospitals, Canada, from 2015 to 2020. Patients and Methods We retrospectively analyzed the medical records of 174 patients undergoing noncardiac surgeries who experienced perioperative hypertension. We assessed the prevalence of 10 reasons for perioperative hypertension as a whole and also each period separately according to the physicians’ notes in patients’ medical records. Two-way measurements ANOVA was used to determine the change of mean hypertension among patients for specific etiology. Results The common etiologies of perioperative hypertension were poorly controlled hypertension (21.8%), excessive fluid therapy (19.5%), excessive vasopressor (18.4%), and medication withdrawal (13.7%). Regarding each period separately, the most common reasons were poorly controlled hypertension for pre (42.9%) and intraoperative period (22.7%) and fluid overload for the postoperative period (20.1%). Poor control of hypertension showed both within-subject statistical significance for systolic and between-subject statistical significance for diastolic blood pressure. Conclusion Poorly controlled hypertension is the most significant etiology of perioperative hypertension in patients undergoing noncardiac surgeries. Apart from poorly controlled hypertension, as a patient-related factor, iatrogenic factors such as excessive vasopressor therapy, aggressive fluid replacement and poor management of antihypertensive medications can also cause perioperative hypertension.
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来源期刊
Integrated Blood Pressure Control
Integrated Blood Pressure Control PERIPHERAL VASCULAR DISEASE-
CiteScore
4.60
自引率
0.00%
发文量
13
审稿时长
16 weeks
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