四肢骨折患者全麻苏醒期发生高血压的危险因素研究

目的通过分析比较四肢骨折患者不同特征间苏醒期的血压，探讨苏醒期高血压发生的危险因素。方法调查2012年1月--2013年6月因四肢骨折而入院并择期行全麻骨科手术的患者120例，采用多因素Logistic回归分析其麻醉苏醒期高血压的危险因素。结果年龄、基础血压、疼痛程度、手术类型等因素是苏醒期发生高血压的危险因素（P〈0．05），960岁、有高血压史、基础血压≥140mmHg（1mmHg：0．133kPa）、重度疼痛、关节置换术的患者苏醒期血压更高（P〈0．05）；苏醒期收缩压、舒张压与年龄、基础收缩压、手术疼痛等级呈正相关，与手术种类呈负相关（P〈0．05）。结论高年龄、基础血压过高、有高血压史、疼痛手术特别是关节置换术的四肢骨折患者，苏醒期更容易发生高血压，应及早预防以改善预后。

Risk factors of patients with limb fractures occurring hypertension in recovery period after general anesthesia

Objective To explore the risk factors of patients with limb fractures occurring hypertension in recovery period after general anesthesia. Methods 120 patients with limb fractures admitted to our hospital and received general anesthe- sia for surgery were enrolled, the multivariate logistic regression analysis was used to explore the risk factors of hyperten- sion in recovery period. Results Age, baseline blood pressure, pain, surgery type were the risk factors hypertension in re- covery period （ P 〈 0.05 ）. ≥60, with history of hypertension, baseline blood pressure ≥ 140 mm Hg, severe pain, joint re- placement surgery group showed a higher blood pressure in recovery period （ P 〈 0.05 ）. Conclusion Age, high baseline blood pressure, with history of hypertension, severe pain and joint replacement surgery were more prone to high blood pres- sure in recovery period. So it should be prevented earlier in order to improve the prognosis.