Lee Seohee, Chung Jaeyeon, Bae Jinyoung, Cho Youn Joung, Nam Karam, Jeon Yunseok
Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul 03080, Korea.
J Clin Med. 2020 Nov 10;9(11):3615. doi: 10.3390/jcm9113615.
Measuring blood pressure (BP) via a pneumatic cuff placed around the arm has long been the standard method. However, in clinical situations where BP monitoring at the arm is difficult, the ankle is frequently used instead. We compared continuous non-invasive blood pressure (CNBP) measurements obtained at the finger, ankle BP and arm BP in patients undergoing breast cancer surgery. Arm BP, ankle BP (both obtained with a conventional pneumatic cuff) and CNBP measurements were obtained every 2.5 min during surgery. Correlation and Bland-Altman analyses were performed and differences among measurements were analyzed using a linear mixed model. A total of 245 sets of BP measurements were obtained from 10 patients. All systolic blood pressure (SBP), diastolic blood pressure (DBP) and mean blood pressure (MBP) measurements of ankle BP and CNBP were positively correlated with the arm BP measurements (Spearman rho 0.688-0.836, < 0.001 for each correlation). The difference between CNBP and arm SBP was significantly smaller (least squares mean (95% confidence interval): -6.03 (-11.40, -0.67)) compared to that between ankle and arm SBP (least squares mean (95% CI): -15.32 (-20.69, -9.96), = 0.019). However, this significant difference was not observed in DBP and MBP (-1.23 vs. 1.75, = 0.190 and -3.85 vs. -2.63, = 0.604, respectively). Ankle SBP measurements showed larger differences from arm SBP measurements than did CNBP SBP measurements in patients undergoing breast cancer surgery. CNBP could serve as a useful alternative to ankle BP when standard arm BP measurements cannot be obtained.
长期以来，通过环绕手臂的气动袖带测量血压（BP）一直是标准方法。然而，在手臂进行血压监测困难的临床情况下，常改用脚踝进行测量。我们比较了乳腺癌手术患者手指处的连续无创血压（CNBP）测量值、脚踝血压和手臂血压。手术期间每2.5分钟获取一次手臂血压、脚踝血压（均使用传统气动袖带获取）和CNBP测量值。进行了相关性分析和Bland-Altman分析，并使用线性混合模型分析测量值之间的差异。共从10名患者处获得了245组血压测量值。脚踝血压和CNBP的所有收缩压（SBP）、舒张压（DBP）和平均血压（MBP）测量值均与手臂血压测量值呈正相关（Spearman相关系数为0.688 - 0.836，各相关性的P < 0.001）。与脚踝和手臂SBP之间的差异（最小二乘均值（95%置信区间）：-15.32（-20.69，-9.96），P = 0.019）相比，CNBP与手臂SBP之间的差异显著更小（最小二乘均值（95%置信区间）：-6.03（-11.40，-0.67））。然而，在DBP和MBP中未观察到这种显著差异（分别为-1.23对1.75，P = 0.190和-3.85对-2.63，P = 0.604）。在接受乳腺癌手术的患者中，脚踝SBP测量值与手臂SBP测量值的差异比CNBP SBP测量值更大。当无法获得标准的手臂血压测量值时，CNBP可作为脚踝血压的有用替代方法。
