当代医学
噹代醫學
당대의학
CHINA CONTEMPORARY MEDICINE
2014年
26期
1-2,3
,共3页
硝酸甘油%乌拉地尔%高血压急症%疗效分析
硝痠甘油%烏拉地爾%高血壓急癥%療效分析
초산감유%오랍지이%고혈압급증%료효분석
Nitroglycerin%Urapidil%Hypertensive emergency%Efficacy analysis
目的探讨乌拉地尔联合硝酸甘油治疗高血压急症的临床效果。方法回顾性分析上海市普陀区利群医院急诊科自2008年9月～2011年9月收治的242例高血压急症患者的临床资料，按治疗方案不同随机分为硝酸甘油组(A组，n=81)、乌拉地尔组(B组，n=81)和硝酸甘油+乌拉地尔组(C组，n=80)。A组：应用硝酸甘油针15 mg加入5%葡萄糖溶液250 mL中,以10μg/min开始,根据血压下降情况调整剂量,但最大剂量不易超过100μg/min；B组：应用盐酸乌拉地尔注射液首剂12.5 mg稀释于20 mL生理盐水中于10 min静脉注射完,继以62.5 mg稀释于50 mL生理盐水中视病情以10～20 mg/h微量泵注射；C组：硝酸甘油和乌拉地尔同时治疗。观察患者在治疗后5、10、20、30、60及90 min时血压改变情况,监测患者心率和临床症状、体征等变化情况，并记录不良反应情况。结果乌拉地尔联合硝酸甘油组用药后各时段血压较用药前均显著下降，总有效率明显升高，不良反应发生率低，差异有统计学意义（P<0.05）。各组心率改变不明显，差异无统计学意义。结论乌拉地尔联合硝酸甘油治疗高血压急症较单用硝酸甘油和乌拉地尔有效，且不良反应少，值得推广。
目的探討烏拉地爾聯閤硝痠甘油治療高血壓急癥的臨床效果。方法迴顧性分析上海市普陀區利群醫院急診科自2008年9月～2011年9月收治的242例高血壓急癥患者的臨床資料，按治療方案不同隨機分為硝痠甘油組(A組，n=81)、烏拉地爾組(B組，n=81)和硝痠甘油+烏拉地爾組(C組，n=80)。A組：應用硝痠甘油針15 mg加入5%葡萄糖溶液250 mL中,以10μg/min開始,根據血壓下降情況調整劑量,但最大劑量不易超過100μg/min；B組：應用鹽痠烏拉地爾註射液首劑12.5 mg稀釋于20 mL生理鹽水中于10 min靜脈註射完,繼以62.5 mg稀釋于50 mL生理鹽水中視病情以10～20 mg/h微量泵註射；C組：硝痠甘油和烏拉地爾同時治療。觀察患者在治療後5、10、20、30、60及90 min時血壓改變情況,鑑測患者心率和臨床癥狀、體徵等變化情況，併記錄不良反應情況。結果烏拉地爾聯閤硝痠甘油組用藥後各時段血壓較用藥前均顯著下降，總有效率明顯升高，不良反應髮生率低，差異有統計學意義（P<0.05）。各組心率改變不明顯，差異無統計學意義。結論烏拉地爾聯閤硝痠甘油治療高血壓急癥較單用硝痠甘油和烏拉地爾有效，且不良反應少，值得推廣。
목적탐토오랍지이연합초산감유치료고혈압급증적림상효과。방법회고성분석상해시보타구리군의원급진과자2008년9월～2011년9월수치적242례고혈압급증환자적림상자료，안치료방안불동수궤분위초산감유조(A조，n=81)、오랍지이조(B조，n=81)화초산감유+오랍지이조(C조，n=80)。A조：응용초산감유침15 mg가입5%포도당용액250 mL중,이10μg/min개시,근거혈압하강정황조정제량,단최대제량불역초과100μg/min；B조：응용염산오랍지이주사액수제12.5 mg희석우20 mL생리염수중우10 min정맥주사완,계이62.5 mg희석우50 mL생리염수중시병정이10～20 mg/h미량빙주사；C조：초산감유화오랍지이동시치료。관찰환자재치료후5、10、20、30、60급90 min시혈압개변정황,감측환자심솔화림상증상、체정등변화정황，병기록불량반응정황。결과오랍지이연합초산감유조용약후각시단혈압교용약전균현저하강，총유효솔명현승고，불량반응발생솔저，차이유통계학의의（P<0.05）。각조심솔개변불명현，차이무통계학의의。결론오랍지이연합초산감유치료고혈압급증교단용초산감유화오랍지이유효，차불량반응소，치득추엄。
Objective To investigate the efficacy of urapidil combined with Nitroglycerin for hypertensive emergency treatment of hypertension nitroglycerin acute clinical effects.Methods The clinical efficacy data of 242 patients hypertensive emergency in our hospital from Sep.2008 to Sep.2011 were retrospectively analyzed.All cases were divided into nitroglycerin group (A group,n=81), Urapidil group (B group,n=81) and urapidil combined with nitroglycerin group(C group,n=80). A group: joined with the Nitroglycerin needle 15mg in 250ml 5% glucose solution , initially 10μg/min, titrated with blood pressure, but it is not easy to exceed the maximum dose which was 100μg/min. B group: joined with the urapidil 12.5mg in 20ml normal saline , initially 6.25μg/min, titrated with blood pressure. C group: Treatment of urapidil combined with nitroglycerin group was given. The changes of blood pressure in the situation was observed in patients at the time which was after treatment 5, 10, 20, 30, 60 and 90min, heart rate, adverse reactions ,clinical symptoms and signs were recorded.Results After treatment, blood pressure in C group was lower, total efficiency was significantly higher, incidence of adverse reactions was lower than that of other groups, the difference was significant, (P<0.05). The changes of heart rate in each group was not significant, the difference was not significant.Conclusion Urapidil combined treatment of hypertensive emergencies than nitroglycerin alone nitroglycerin and urapidil effective, and adverse reactions, it is worth promoting.
