| Summary: | 碩士 === 國立臺灣師範大學 === 健康促進與衛生教育學系 === 106 === Abstract This study aimed to identify factors that affect intraoperative blood pressure in hypertensive patients receiving laparoscopic cholecystectomy at a medical center, using retrospective chart-review method. The perioperative medical records of all hypertensive patients who received laparoscopic cholecystectomy over 18 months (January 2016 to June 2017) was examined, with the following results:
1. A total number of 325 patients were eligible and selected for data processing and statistical analysis. Of all the patients in this study, the male (n=167) to female (n=158) ratio was 1.057. 75% of patients (n=245) were in the age range of 50 to 79 years old. 67% of patients were overweight or obese. 59.4% of patients administered antihypertensive drugs before surgery. Nearly half of the patients had a family history of hypertension. In total, 38.5% of patients developed intraoperative blood pressure instability.
2. Risk factors of ‘age’, ‘body mass index’ and ‘administration of anti-hypertensive drugs before surgery’ were found to influence blood pressure during surgery. The more advanced the age, the more unstable the blood pressure during surgery. In contrast, higher body mass index and those who received anti-hypertensive drugs resulted in more stable intraoperative blood pressure.
3. Background variables such as gender, age, body mass index, status of anti-hypertensive drugs taken before operation, and family history of hypertension can help predict blood pressure stability during surgery (R 2= 0.318). Amongst the background variables, status of anti-hypertensive drugs taken before operation was identified as the most significant predictor variable for intraoperative blood pressure stability.
Conclusion: Status of anti-hypertensive drugs taken before operation is a significant predictor for perioperative blood pressure stability. Therefore, patients with long-term hypertension under medication control should be instructed to take anti-hypertensive medications before surgery to help maintain stable perioperative blood pressure.
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