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Aneth Analg：结直肠手术后低血压和手术部位感染的关系：回顾性队列研究

2018-11-30 王子君 "罂粟花”微信号

关注

术后时间加权平均动脉压与手术部位感染无关，但与术后最低平均动脉压有关。这种关系是否存在因果关系仍有待证明。

背景与目的

低血压可损害局部组织灌注，从而减少组织氧合，因此低血压可能会促进组织感染。在外科病房发生的低血压虽然通常不如术中低血压严重，但常见且病程较长。在这项回顾性队列研究中，我们假设手术部位的感染与术后时间加权平均动脉压和/或术后最小平均动脉压的降低之间存在关联。

方  法

我们纳入了2009年至2013年间在克利夫兰诊所进行结直肠手术持续≥1小时的患者。我们将血压的指标定义为手术后72小时内的时间加权平均值（初级）和最小平均动脉压（次级）。我们使用单独的严重程度加权平均相对效应广义估计方程模型来评估连续血压值与深部、浅表手术部位复合感染之间的关联，每个模型使用非结构化相关结构并调整潜在的混杂变量。

结  果

共有5896名患者符合分析条件。时间加权平均动脉压和手术部位感染无明显相关性，5 mmHg下降的优势比（95％CI）为1.03（0.99-1.08）（P = .16）。然而，术后最小平均动脉压与感染之间存在明显的负相关性，优势比为每5 mmHg下降1.08（1.03-1.12）（P = .001）。

结  论

术后时间加权平均动脉压与手术部位感染无关，但与术后最低平均动脉压有关。这种关系是否存在因果关系仍有待证明。

原始出处：

Yilmaz， Huseyin D， Babazade， et al. Postoperative Hypotension and Surgical Site Infections After Colorectal Surgery： A Retrospective Cohort Study[J]. Anesthesia & Analgesia， 2018：1.

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    2019-06-27 经常头晕

    #Anal#

    0

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    2019-04-10 canlab

    #NET#

    0

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    2019-07-26 AspirantSuo

    #ANA#

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    2018-12-02 chentianping

    #低血压#

    0

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    2018-12-02 wleon8895

    #手术部位感染#

    0

  6. [GetPortalCommentsPageByObjectIdResponse(id=1700091, encodeId=8f6c1e00091b1, content=<a href='/topic/show?id=295524e541' target=_blank style='color:#2F92EE;'>#Anal#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=47, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2475, encryptionId=295524e541, topicName=Anal)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=de3a29999500, createdName=经常头晕, createdTime=Thu Jun 27 21:23:00 CST 2019, time=2019-06-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1734085, encodeId=66cf1e34085a2, content=<a href='/topic/show?id=d4f412668a4' target=_blank style='color:#2F92EE;'>#NET#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=44, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=12668, encryptionId=d4f412668a4, topicName=NET)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=7ea033781210, createdName=canlab, createdTime=Wed Apr 10 02:23:00 CST 2019, time=2019-04-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1633504, encodeId=4720163350411, content=<a href='/topic/show?id=377824e1c0' target=_blank style='color:#2F92EE;'>#ANA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2471, encryptionId=377824e1c0, topicName=ANA)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=434d22047430, createdName=AspirantSuo, createdTime=Fri Jul 26 12:23:00 CST 2019, time=2019-07-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1367381, encodeId=3a6d136e38191, content=<a href='/topic/show?id=f4012634656' target=_blank style='color:#2F92EE;'>#低血压#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=50, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=26346, encryptionId=f4012634656, topicName=低血压)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=f634250, createdName=chentianping, createdTime=Sun Dec 02 00:23:00 CST 2018, time=2018-12-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1370542, encodeId=5cd413e05425b, content=<a href='/topic/show?id=00505450e5f' target=_blank style='color:#2F92EE;'>#手术部位感染#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=54507, encryptionId=00505450e5f, topicName=手术部位感染)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4cce318, createdName=wleon8895, createdTime=Sun Dec 02 00:23:00 CST 2018, time=2018-12-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1453193, encodeId=c66f145319314, content=<a href='/topic/show?id=098ee8679ad' target=_blank style='color:#2F92EE;'>#结直肠#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=78679, encryptionId=098ee8679ad, topicName=结直肠)], attachment=null, authenticateStatus=null, createdAvatar=/v1.0.0/img/user_icon.png, createdBy=9ace5575596, createdName=crystal0564, createdTime=Sun Dec 02 00:23:00 CST 2018, time=2018-12-02, status=1, ipAttribution=)]
    2018-12-02 crystal0564

    #结直肠#

    0