生命体征与异位妊娠破裂导致的腹腔积血不相关。

Vital signs fail to correlate with hemoperitoneum from ruptured ectopic pregnancy.

作者信息

Hick J L, Rodgerson J D, Heegaard W G, Sterner S

机构信息

University of Minnesota, Hennepin County Medical Center, Minneapolis, MN, USA.

出版信息

Am J Emerg Med. 2001 Oct;19(6):488-91. doi: 10.1053/ajem.2001.27133.

DOI:10.1053/ajem.2001.27133

PMID:11593468

Abstract

The objective was to determine correlation between vital signs and hemoperitoneum in ruptured ectopic pregnancy. A retrospective chart review of ectopic pregnancies at our urban county hospital between 1990 and 1998 was conducted. Fifty-one cases met inclusion criteria. Mean minimum systolic blood pressure (SBP) 89mmHg (range 40-118), mean maximum heart rate (HR) 101 beats/min (range 62-156). Mean volume of hemoperitoneum 1,050 mL (range 400-2,000 mL). Correlation between vital signs and volume of hemoperitoneum was poor (R(2) = 0.04 for HR, R(2) = 0.1 for SBP). Association of tachycardia with hypotension was also poor (R(2) = 0.1). Extreme individual variations were observed. If surgical decisions were made on the basis of hypotension, 38% of patients could have received either inappropriate additional studies or surgical approach. Patients with normal vital signs had a 20% chance of having class IV blood loss at surgery. HR and blood pressure do not correlate well with volumes of hemoperitoneum from ruptured ectopic pregnancy.

摘要

目的是确定破裂异位妊娠中生命体征与腹腔内出血之间的相关性。对1990年至1998年间我院城市县级医院的异位妊娠病例进行了回顾性图表审查。51例符合纳入标准。平均最低收缩压（SBP）89mmHg（范围40 - 118），平均最高心率（HR）101次/分钟（范围62 - 156）。平均腹腔内出血量1050 mL（范围400 - 2000 mL）。生命体征与腹腔内出血量之间的相关性较差（心率的R² = 0.04，收缩压的R² = 0.1）。心动过速与低血压之间的关联也较差（R² = 0.1）。观察到个体差异极大。如果根据低血压做出手术决策，38%的患者可能接受了不适当的额外检查或手术方式。生命体征正常的患者在手术时发生IV级失血的几率为20%。心率和血压与破裂异位妊娠的腹腔内出血量相关性不佳。