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无创血红蛋白监测在小儿头面部手术中的应用
Application of noninvasive hemoglobin monitoring in children undergoing craniofacial operation
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DOI:
作者:
李怡然,姜虹
LI Yiran,JIANG Hong
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麻醉科
Shanghai Jiao Tong University School of Medicine Department of Anesthesiology, Shanghai Ninth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine
关键词:
连续无创血红蛋白;动脉血气血红蛋白;小儿手术
Continuous noninvasive hemoglobin; Arterial blood gas hemoglobin; Children operation
摘要:
目的 评价Masimo SET Radical-7 Pulse CO-Oximeter监测仪(美国Masimo公司)连续、无创、实时监测血红蛋白水平(SpHb)在小儿头面部手术中的临床价值。 方法 选择30例头面部手术小儿患者,用Masimo SET Radical-7 Pulse CO-Oximeter监测仪持续监测SpHb。分别于麻醉诱导后5min,切皮后5min,术中每2h,术毕即刻各个时间点记录SpHb值,同时于各个时间点采集动脉血样本即刻行血气分析测定血红蛋白值(Hbsatlab),对应记录后进行相关分析。 结果 Pearson相关性分析表明SpHb与Hbsatlab呈线性相关,相关方程为y=2.63+0.75x,相关系数r=0.622,P<0.001。Bland-Altman一致性分析显示SpHb与Hbsatlab一致性良好,两者差值的平均偏倚0.43g/dL,95%一致性界限范围-0.6~1.5g/dL。 结论 小儿头面部术中连续无创血红蛋白监测准确性良好,为术中输液输血提供实时客观依据。
Objective To evaluate the value of continuous noninvasive hemoglobin (SpHb) measured by Masimo SET Radical-7 Pulse CO-Oximeter (Masimo CO, U.S.A.) in children undergoing craniofacial operation. Methods Thirty child patients undergoing craniofacial operation were enrolled in this study. SpHb was monitored continually and recorded 5 minutes after induction of anesthesia, 5 minutes after skin incision, every 2 hours during the surgery, and at the end of surgery. The arterial blood samples were collected and invasive hemoglobin (Hbsatlab) levels were measured at above mentioned time points. Hbsatlab levels were compared with the corresponding SpHb. Results Pearson correlation analysis displayed that SpHb had a linear correlation with Hbsatlab. The regression equation was y=2.63+0.75x, r=0.622, P<0.001. Bland-Altman analysis showed SpHb to Hbsatlab values were in good consistence. The mean difference between SpHb and Hbsatlab was 0.43g/dL with 95% CI being -0.6 to 1.5 g/dL. Conclusion Continuous noninvasive hemoglobin measurement is an accurate method to monitor hemoglobin level in children undergoing craniofacial operation which can provide objective evidence for clinicians of fluid and blood transfusion.
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