老年高血压前期患者围手术期血流动力学波动的现状调查及相关因素分析OA

Objective To observe the incidence of perioperative hemodynamic fluctuations in elderly patients with prehypertension and normal blood pressure,and to analyze the related factors of hemodynamic fluctuations in elderly patients with prehypertension.Methods From January to December 2020,139 normotensive patients and 150 prehypertensive patients aged≥60 years who underwent general anesthesia in our hospital were selected as the research objects.The baseline data were collected.The first blood pressure after entering the room,the fluctuation of intraoperative heart rate,the incidence of intraoperative hypotension,the use of perioperative antihypertensive drugs and the incidence of intraoperative hemodynamic fluctuations were measured.The influencing factors of hemodynamic fluctuations in elderly patients with prehypertension were analyzed.Results There was no significant difference in age,ASA grade,gender,BMI,admission HR,preoperative diabetes,blood lipid and intraoperative hypotension between the two groups(P>0.05),while there was significant difference in hypertension,use of antihypertensive drugs and HR fluctuation between the two groups(P<0.05).Univariate analysis showed that preoperative diabetes mellitus,age≥70 years old and operation time were the influencing factors of perioperative hemodynamic fluctuation in elderly patients with prehypertension(P<0.05).Multivariate Logistic regression analysis showed that age≥70 years and preoperative diabetes mellitus were the influencing factors of perioperative hemodynamic fluctuations in elderly patients with hypertension(P<0.05).Conclusion Compared with patients with normal blood pressure,patients with prehypertension are more prone to hemodynamic fluctuations during perioperative period.Preoperative diabetes mellitus and age≥70 years are risk factors for perioperative hemodynamic fluctuations in elderly patients with prehypertension.