高血压病人气管插管/拔管期心血管反应的药物控制

目的: 探讨乌拉地尔及硝酸甘油控制高血压病人插管与拔管期心血管反应的有效性。方法: 45例原发性高血压全麻病人, 随机分为乌拉地尔组(U组, n =15)、 硝酸甘油组(N 组, n =15) 和对照组(C组, n =15), 分别于诱导时和术毕静注乌拉地尔0.5 mg·kg^-1或硝酸甘油 1 μg·kg^-1或不用降压药,观察插管期及拔管期收缩压(SBP)、 舒张压(DBP)、 平均动脉压(MAP)、 心率(HR)、 和心率 收缩压乘积(RPP)。 结果: 插管与拔管期C 组心血管反应剧烈,各项观察指标均异常升高(P <0.01); U 组和 N 组SBP、 DBP、 MAP 平稳, 分别与 C 组同期比较均有非常显著性差异(P <0.01), U 组与 N 组间比较无统计学差异; U 组和N 组HR、RPP 虽有升高, 但升高幅度均 低 于 C 组 (P <0.01)。 结论: 乌 拉 地 尔0.5 mg·kg^-1或硝酸甘油 1 μg·kg^-1静注均能有效控制插管与拔管刺激引起的心血管反应, 有助于高血压病人插管与拔管期维持血流动力学相对稳定。

Urapidil and nitroglycerine for the control of cardiovascular responses to tracheal intubation/extubation in patients with essential hypertension

AIM: To study the effectiveness of ura-pidil and nitroglycerine on controlling the cardiovascular responses to tracheal intubation/extubation in patients with essential hypertension.METHODS: 45 patients with essential hypertension undergoing general anesthesia were divided randomly into control (C, without depres-sor, n =15), urapidil (U, 0.5 mg·kg^-1, n =15), and nitroglycerine (N, 1 μg·kg^-1, n =15) groups.The SBP, DBP, MAP, HR and RPP were measured during intubation and extubation and at the induction of anesthe-sia and the end of operation respectively. RESULTS: The SBP, DBP, MAP, HR and RPP increased markedly (P <0.01) in group C, but SBP, DBP, and MAP re-mained stable in group U and group N;compared with group C, there were significant difference in the same pe-riods during tracheal intubaton/extubation respectively (P <0.01). The raising levels of HR, RPP in group U and groupN were lower significantly than those in group C (P <0.01). CONCLUSION: Urapidil and nitroglycerine can reduce the cardiovascular responses to tracheal intu-bation/extubation effectively, and be helpful in keeping the hemodynamic stability, especially in patients with es-sential hypertension.