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使用飞利浦Intellivue MP50监护仪进行无创血压监测不能替代全身麻醉下手术患者的有创血压监测技术。

Non-invasive monitoring of blood pressure using the Philips Intellivue MP50 monitor cannot replace invasive blood pressure techniques in surgery patients under general anesthesia.

作者信息

Meng Xianghu, Zang Guanghui, Fan Longchang, Zheng Lei, Dai Jinzhen, Wang Xueren, Xia Wei, Liu Jihong, Zhang Chuanhan

机构信息

Departments of Urology, Huazhong University of Science and Technology, Wuhan, Hubei 430030;

出版信息

Exp Ther Med. 2013 Jul;6(1):9-14. doi: 10.3892/etm.2013.1121. Epub 2013 May 17.

Abstract

The Philips Intellivue MP50 monitor provides a method for non-invasive, near-continuous blood pressure (BP) monitoring and is designed to be an alternative to direct intra-arterial BP (IABP) measurement. However, no studies have specifically compared non-invasive and invasive BP measurements using the monitor. The present retrospective study observed 515 patients undergoing surgery with general anesthesia, whose invasive (intra-radial, femoral or dorsalis pedis artery) and non-invasive (oscillometric) BP (NIBP) were monitored simultaneously using the monitor. These data were analyzed using correlations, regressions and Bland-Altman plots. The patients were placed in a supine position during surgery. The correlation data for invasive BP and NIBP measurements were: for intra-radial measurements, r=0.51 (bias and precision, 11.04±15.22 and 14.76±11.64 mmHg, respectively) for systolic BP (SBP) and r=0.27 (6.17±11.95 and 9.77±9.25 mmHg, respectively) for diastolic BP (DBP); for intra-femoral measurements: r=0.57 (14.79±14.55 and 17.15±11.68 mmHg, respectively) for SBP and r=0.45 (4.12±9.70 and 7.49±7.40 mmHg, respectively) for DBP; and for intra-dorsalis pedis measurements: r=0.33 (13.00±16.81 and 17.34±12.28 mmHg, respectively) for SBP and r=0.30 (0.17±11.27 and 8.44±7.46 mmHg, respectively) for DBP. According to this data, the NIBP measured by the Philips Intellivue MP50 monitor showed low positive correlations and poor agreement with the IABP, as calculated by Bland-Altman analysis. Therefore, the use of oscillometric BP measured by the monitor in surgery patients under general anesthesia is not generally recommended.

摘要

飞利浦Intellivue MP50监护仪提供了一种无创、近连续血压(BP)监测方法,旨在替代直接动脉内血压(IABP)测量。然而,尚无研究专门比较使用该监护仪进行的无创和有创血压测量。本回顾性研究观察了515例接受全身麻醉手术的患者,使用该监护仪同时监测其有创(桡动脉、股动脉或足背动脉内)和无创(示波法)血压(NIBP)。使用相关性、回归分析和Bland-Altman图对这些数据进行分析。手术期间患者取仰卧位。有创血压和无创血压测量的相关性数据如下:对于桡动脉内测量,收缩压(SBP)的r=0.51(偏差和精密度分别为11.04±15.22和14.76±11.64 mmHg),舒张压(DBP)的r=0.27(分别为6.17±11.95和9.77±9.25 mmHg);对于股动脉内测量:SBP的r=0.57(分别为14.79±14.55和17.15±11.68 mmHg),DBP的r=0.45(分别为4.12±9.70和7.49±7.40 mmHg);对于足背动脉内测量:SBP的r=0.33(分别为13.00±16.81和17.34±12.28 mmHg),DBP的r=0.30(分别为0.17±11.27和8.44±7.46 mmHg)。根据这些数据,通过Bland-Altman分析计算得出,飞利浦Intellivue MP50监护仪测量的NIBP与IABP显示出低正相关性和较差的一致性。因此,一般不建议在全身麻醉的手术患者中使用该监护仪测量的示波法血压。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2698/3735910/2ba8a4718408/ETM-06-01-0009-g00.jpg

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