于靖, 陶日鑫, 王帅. 急诊创伤患者围手术期高血压的危险因素分析及管理建议[J]. 职业卫生与应急救援, 2023, 41(2): 156-160. DOI: 10.16369/j.oher.issn.1007-1326.2023.02.007
引用本文: 于靖, 陶日鑫, 王帅. 急诊创伤患者围手术期高血压的危险因素分析及管理建议[J]. 职业卫生与应急救援, 2023, 41(2): 156-160. DOI: 10.16369/j.oher.issn.1007-1326.2023.02.007
YU Jing, TAO Rixin, WANG Shuai. Analysis of risk factors for perioperative hypertension in emergency trauma patientsand management suggestions[J]. Occupational Health and Emergency Rescue, 2023, 41(2): 156-160. DOI: 10.16369/j.oher.issn.1007-1326.2023.02.007
Citation: YU Jing, TAO Rixin, WANG Shuai. Analysis of risk factors for perioperative hypertension in emergency trauma patientsand management suggestions[J]. Occupational Health and Emergency Rescue, 2023, 41(2): 156-160. DOI: 10.16369/j.oher.issn.1007-1326.2023.02.007

急诊创伤患者围手术期高血压的危险因素分析及管理建议

Analysis of risk factors for perioperative hypertension in emergency trauma patientsand management suggestions

  • 摘要:
      目的  分析急诊创伤患者围手术期高血压的危险因素,并提出针对性的管理建议。
      方法  回顾性分析2020年3月—2021年12月收治的168例急诊创伤患者的临床资料,记录患者围手术期高血压的发生情况,根据患者在围手术期是否发生高血压将其分为高血压组和非高血压组,比较两组患者的一般资料,采用多因素logistic回归模型分析急诊创伤患者围手术期高血压的危险因素。
      结果  168例急诊创伤患者中有47例发生围手术期高血压,发生率为27.98%。logistic回归分析结果显示:相比年龄 < 45岁、ISS评分 < 16分、无糖尿病史的患者,年龄≥ 45岁、ISS评分≥16分、有糖尿病史的患者在围手术期发生高血压的风险分别增加至2.217、2.416、1.984倍(P < 0.05);CRP每增加1.0 mg/L,患者发生高血压的风险增加至1.200倍(P < 0.05)。针对术后高血压组患者的降压治疗的有效率为82.98%。两组患者住院时间差异无统计学意义(P>0.05);高血压组肾功能异常、心力衰竭发生率分别为8.51%、12.77%,均高于非高血压组的0.83%、4.13%,差异有统计学意义(P < 0.05)。
      结论  对于高龄、有糖尿病史、CRP水平过高的急性创伤患者应加强血压监测,注意肾功能和心功能相关指标的变化,进行针对性管理,以降低急性创伤患者的救治风险。

     

    Abstract:
      Objective  To analyze the risk factors for perioperative hypertension in patients with emergency trauma and put forward suggestions for management.
      Methods  The clinical data of 168 patients with emergency trauma from March 2020 to December 2021 were analyzed retrospectively, and the incidence of perioperative hypertension was recorded. According to the occurrence of perioperative hypertension, the patients were divided into a hypertension group and a non-hypertension group. The general data of the two groups were compared. A multivariate logistic regression model was used to analyze the risk factors for perioperative hypertension in patients with emergency trauma.
      Results  Among 168 patients with emergency trauma, 47 developed perioperative hypertension with an incidence of 27.98%. The results of the logistic regression analysis showed that, compared with the patients aged less than 45 years, with an ISS score less than 16, or without a history of diabetes, the perioperative risk of hypertension in patients aged more than or equal to 45 years, with an ISS score more than or equal to 16, or with a history of diabetes, increased by 2.217, 2.416, and 1.984 times, respectively. The risk of hypertension increased by 1.200 times when CRP increased by 1.0 mg/L. The effective rate of antihypertensive therapy for patients with postoperative hypertension was 82.98%. There was no significant difference in hospitalization time between the two groups (P>0.05). The incidences of abnormal renal function and heart failure in the hypertension group were 8.51% and 12.77%, respectively, which were higher than 0.83% and 4.13% in the non-hypertension group, and the difference was statistically significant (P<0.05).
      Conclusions  In order to reduce the treatment risk of acute trauma patients with advanced age, a history of diabetes, and a high level of CRP, we should strengthen blood pressure monitoring, pay attention to the changes in related indexes of renal function and cardiac function, and carry out targeted management.

     

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