无创血红蛋白监测在小儿头面部手术中的应用

发布时间：2018-05-02 15:13

本文选题：连续无创血红蛋白 + 动脉血气血红蛋白　；参考：《上海医学》2015年04期

【摘要】：目的评价应用Masimo SET Radical-7Pulse CO-Oximeter监测仪(美国Masimo公司)连续、无创、实时监测血红蛋白(Hb)水平在小儿头面部手术中的临床应用价值。方法选择择期在气管插管全身麻醉下行头面部手术的患儿30例,分别于麻醉诱导后5min、切皮后5min和术毕即刻各时间点,记录应用Masimo SET Radical-7Pulse CO-Oximeter监测仪连续实时无创地监测的Hb水平(SpHb)和采集动脉血样本即刻行血气分析测定的Hb水平(Hbsatlab),并对两者进行相关性分析和一致性分析。结果 Pearson相关性分析结果表明,以SpHb值为自变量x,Hbsatlab值为应变量y,两者呈线性相关,相关方程为y=26.35+0.75x,相关系数r=0.622,P0.001。Bland-Altman一致性分析结果显示,差值的平均偏倚为4.3g/L,95%CI(一致性界限)为-6~15g/L,1.1%(1/90)的点在一致性界限外,两种方法测得的Hb值具有较好的一致性。结论在小儿头面部术中采用连续无创Hb监测的准确性良好,能为术中输液、输血提供实时客观依据。
[Abstract]:Objective to evaluate the clinical value of continuous, noninvasive and real time monitoring of hemoglobin with Masimo SET Radical-7Pulse CO-Oximeter monitor (Masimo Company) in pediatric head and facial surgery. Methods Thirty children undergoing craniofacial surgery under tracheal intubation under general anesthesia were selected at 5 minutes after anesthesia induction, 5min after skin incision and at each time point immediately after operation. The HB levels monitored continuously and noninvasively by Masimo SET Radical-7Pulse CO-Oximeter monitor and the HB levels measured by blood gas analysis were recorded. The correlation analysis and consistency analysis were carried out between the two groups. Results the results of Pearson correlation analysis showed that the SpHb value was regarded as the dependent variable, and the correlation equation was y 26.35 0.75 x, and the correlation coefficient was 0. 622 P 0.001. Bland-Altman consistency analysis showed that there was a linear correlation between the two variables, and the correlation coefficient was 0. 622% P 0. 001.Bland-Altman consistency analysis. The average bias of the difference is 4.3 g / L ~ (95) CI (consistency limit) = -6 ~ (15) g / L ~ (-1) / L ~ (-1 / 90). Outside the consistency limit, the HB values obtained by the two methods are in good agreement. Conclusion the accuracy of continuous non-invasive HB monitoring in pediatric cephalofacial surgery is good and can provide real-time objective basis for intraoperative infusion and blood transfusion.
【作者单位】：上海交通大学医学院;上海交通大学医学院附属第九人民医院手术麻醉科;
【分类号】：R726.1

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