摘要
Abstract
Objective To investigate the predictive value of intraoperative blood pressure variability(BPV)for tourniquet-induced hypertension(TIH)in arthroscopic anterior cruciate ligament(ACL)reconstruction.Methods 129 patients who underwent arthroscopic ACL reconstruction from January 2023 to September 2024 were selected.The endpoint of observation was the occurrence of TIH or the end of operation.The patients were divided into the TIH group(49 cases)and the non-TIH group(80 cases)according to whether TIH occurred during operation.The clinical data of patients were collected,and the intraoperative BPV related indexes were calculated and analyzed.Multivariate Logistic regression analysis was used to analyze the risk factors of TIH in patients undergoing ACL reconstruction.The receiver operating characteristic curve(ROC curve)was drawn,and the area under the curve(AUC)was calculated to analyze the predictive value of BPV related indexes.Results 129 patients were included in this study,and 49 patients developed TIH,accounting for 37.98%(49/129).Compared with the non-TIH group,the tourniquet use time in the TIH group was significantly longer,the tourniquet pressure was significantly higher,the systolic blood pressure-coefficient of variation(SBP-CV)and mean arterial pressure-coefficient variation(MAP-CV)were significantly higher,the differences were statistically significant(P<0.05).Multivariate Logistic regression analysis showed that tourniquet pressure>351 mmHg,SBP-CV>8.72%and MAP-CV>5.14%were independent risk factors for TIH in patients undergoing arthroscopic ACL reconstruction(P<0.05).ROC curve analysis showed that the AUC of SBP-CV and MAP-CV in predicting TIH in patients undergoing ACL reconstruction were 0.787(95%CI:0.702～0.872)and 0.791(95%CI:0.715～0.867),respectively.Conclusion Tourniquet pressure,SBP-CV and MAP-CV are related to TIH in patients undergoing arthroscopic ACL reconstruction,and MAP-CV and SBP-CV show good predictive ability for TIH,which can be used as an important indicator of postoperative monitoring.关键词
血压变异性(BPV)/前交叉韧带(ACL)重建术/止血带/膝关节镜/高血压Key words
blood pressure variability(BPV)/anterior cruciate ligament(ACL)reconstruction/tourniquet/knee arthroscopy/hypertension分类
医药卫生
