老年妇科手术患者全身麻醉诱导后低血压的发生情况及危险因素分析

Analysis of incidence and risk factors for hypotension after general anesthesia induction in elderly patients undergoing gyneco-logical surgery

中文关键词: 老年  妇科手术  全身麻醉诱导  低血压  危险因素  预测模型

英文关键词: elderly  gynecological surgery  induction of general anesthesia  hypotension  risk factor  prediction model

中文摘要:

      目的 探究老年妇科手术患者在全身麻醉诱导后低血压的发生情况,并分析其危险因素.方法 回顾性选取2021年4月-2025年1月于铜陵市妇幼保健院行妇科全麻手术的109例老年患者,根据全身麻醉诱导后是否发生低血压分为低血压组(n=48)和非低血压组(n=61).收集并分析2组患者一般资料,采用单因素分析及多因素Logistic回归方法,分析老年妇科全麻手术患者全身麻醉诱导后发生低血压的危险因素,并构建风险预测模型.结果 全身麻醉诱导后发生低血压的发生率为44.04％,多因素Logistic回归分析发现,患者年龄较大(OR=1.060,P=0.041)、存在高血压病史(OR=6.841,P=0.039)、入室收缩压水平＜130 mmHg(OR=1.096,P=0.007)、使用丙泊酚诱导麻醉(OR=20.264 P=0.007)、使用舒芬太尼诱导麻醉(OR=6.123,P=0.040)、血清HB水平降低(OR=0.924,P=0.018)、TC水平升高(OR=2.464,P=0.027)是导致老年妇科手术患者全身麻醉诱导后发生低血压的独立危险因素.结论 老年妇科手术患者全身麻醉诱导后低血压发生率较高,年龄较大、高血压病史、人室收缩压＜130 mmHg、丙泊酚诱导、舒芬太尼诱导、血清HB水平降低及TC水平升高可能是其独立危险因素,可为临床麻醉管理提供科学参考,有助于降低老年妇科手术患者全身麻醉诱导后低血压的发生风险.

英文摘要:

      Objective To investigate the incidence of hypotension after general anesthesia induction in elderly patients undergoing gynecological surgery and analyze its risk factors.Methods 109 elderly patients who underwent gynecological sur-gery under general anesthesia in Maternal and Child Health Hospital of Tongling City from April 2021 to January 2025 were ret-rospectively selected.According to whether hypotension occurred after induction of general anesthesia,they were divided into hypotension group(n=48)and non-hypotension group(n=61).Their general data were collected and analyzed.Univariate analysis and multivariate Logistic regression analysis were performed to identify risk factors for hypotension after general anes-thesia induction in elderly patients undergoing gynecological surgery,and a risk prediction model was constructed.Results The incidence of hypotension after general anesthesia induction was 44.04％.Multivariate Logistic regression analysis revealed that advanced age(OR=1.060,P=0.041),history of hypertension(OR=6.841,P=0.039),preoperative systol-ic blood pressure＜130 mmHg(OR=1.096,P=0.007),propofol induction(OR=20.264,P=0.007),sufentanil induc-tion(OR=6.123,P=0.040),decreased serum hemoglobin(HB)level(OR=0.924,P=0.018),and elevated total cho-lesterol(TC)level(OR=2.464,P=0.027)were independent risk factors for hypotension after general anesthesia induction in elderly patients undergoing gynecological surgery.Conclusion The incidence of hypotension after general anesthesia induc-tion is high in elderly patients undergoing gynecological surgery.Advanced age,history of hypertension,preoperative systolic blood pressure＜130 mmHg,propofol induction,sufentanil induction,decreased serum HB level,and elevated TC level may be independent risk factors.These findings provide scientific references for clinical anesthesia management and may help reduce the risk of hypotension after general anesthesia induction in elderly patients undergoing gynecological surgery.