中华急诊医学杂志
中華急診醫學雜誌
중화급진의학잡지
CHINESE JOURNAL OF EMERGENCY MEDICINE
2014年
3期
335-339
,共5页
乌拉地尔%硝苯地平%硝酸甘油%急性术后高血压%肿瘤%疗效%安全性%回顾性分析
烏拉地爾%硝苯地平%硝痠甘油%急性術後高血壓%腫瘤%療效%安全性%迴顧性分析
오랍지이%초분지평%초산감유%급성술후고혈압%종류%료효%안전성%회고성분석
Urapidil%Nifedipine%Nitroglycerin%Acute postoperative hypertension%Carcinoma%Treatment effects%Safety%Retrospectively analysis
目的 比较舌下含服硝苯地平、静脉注射乌拉地尔及微量泵入硝酸甘油治疗急性术后高血压(acute postoperative hypertension,APH)的疗效及安全性.方法 对2007年7月至2010年12月期间因肿瘤切除术后出现APH接受降压治疗的497名患者资料进行回顾性分析.入选患者因APH接受降压药物治疗,高血压发生在手术后24h内,而且24 h内未接受任何长效降压药物治疗.既往冠心病、心律失常、脑卒中病史者以及数据不完整者除外.患者分为3组,硝苯地平组:10 mg硝苯地平舌下含服;乌拉地尔组:12.5 mg乌拉地尔加入生理盐水20 mL稀释缓慢静脉注射;硝酸甘油组:25 mg硝酸甘油加入生理盐水40 mL稀释静脉微量泵入.应用x2检验比较不同治疗方式对患者的疗效及安全性.结果 硝苯地平组收缩压平均下降5.8％,舒张压平均下降4.7％;乌拉地尔组收缩压平均下降11.1％,舒张压平均下降8.4％;硝酸甘油组收缩压平均下降13.1％,舒张压平均下降10.2％.乌拉地尔和硝酸甘油的降压达标率差异无统计学意义(63.4％ vs.57.8％,P=0.506),均优于舌下含服硝苯地平(63.4％ vs.33.3％,P=0.000;57.8％ vs.33.3％,P=0.001).乌拉地尔和硝苯地平的心脑血管并发症发生率差异无统计学意义(6.9％vs.4.7％,P =0.345),均明显低于硝酸甘油(24.4％ vs.6.9％,P=0.001;24.4％ vs.4.7％,P=0.000).结论 综合考虑药物的疗效和安全性,静脉注射乌拉地尔比舌下含服硝苯地平和微量泵入硝酸甘油更适合APH的治疗.
目的 比較舌下含服硝苯地平、靜脈註射烏拉地爾及微量泵入硝痠甘油治療急性術後高血壓(acute postoperative hypertension,APH)的療效及安全性.方法 對2007年7月至2010年12月期間因腫瘤切除術後齣現APH接受降壓治療的497名患者資料進行迴顧性分析.入選患者因APH接受降壓藥物治療,高血壓髮生在手術後24h內,而且24 h內未接受任何長效降壓藥物治療.既往冠心病、心律失常、腦卒中病史者以及數據不完整者除外.患者分為3組,硝苯地平組:10 mg硝苯地平舌下含服;烏拉地爾組:12.5 mg烏拉地爾加入生理鹽水20 mL稀釋緩慢靜脈註射;硝痠甘油組:25 mg硝痠甘油加入生理鹽水40 mL稀釋靜脈微量泵入.應用x2檢驗比較不同治療方式對患者的療效及安全性.結果 硝苯地平組收縮壓平均下降5.8％,舒張壓平均下降4.7％;烏拉地爾組收縮壓平均下降11.1％,舒張壓平均下降8.4％;硝痠甘油組收縮壓平均下降13.1％,舒張壓平均下降10.2％.烏拉地爾和硝痠甘油的降壓達標率差異無統計學意義(63.4％ vs.57.8％,P=0.506),均優于舌下含服硝苯地平(63.4％ vs.33.3％,P=0.000;57.8％ vs.33.3％,P=0.001).烏拉地爾和硝苯地平的心腦血管併髮癥髮生率差異無統計學意義(6.9％vs.4.7％,P =0.345),均明顯低于硝痠甘油(24.4％ vs.6.9％,P=0.001;24.4％ vs.4.7％,P=0.000).結論 綜閤攷慮藥物的療效和安全性,靜脈註射烏拉地爾比舌下含服硝苯地平和微量泵入硝痠甘油更適閤APH的治療.
목적 비교설하함복초분지평、정맥주사오랍지이급미량빙입초산감유치료급성술후고혈압(acute postoperative hypertension,APH)적료효급안전성.방법 대2007년7월지2010년12월기간인종류절제술후출현APH접수강압치료적497명환자자료진행회고성분석.입선환자인APH접수강압약물치료,고혈압발생재수술후24h내,이차24 h내미접수임하장효강압약물치료.기왕관심병、심률실상、뇌졸중병사자이급수거불완정자제외.환자분위3조,초분지평조:10 mg초분지평설하함복;오랍지이조:12.5 mg오랍지이가입생리염수20 mL희석완만정맥주사;초산감유조:25 mg초산감유가입생리염수40 mL희석정맥미량빙입.응용x2검험비교불동치료방식대환자적료효급안전성.결과 초분지평조수축압평균하강5.8％,서장압평균하강4.7％;오랍지이조수축압평균하강11.1％,서장압평균하강8.4％;초산감유조수축압평균하강13.1％,서장압평균하강10.2％.오랍지이화초산감유적강압체표솔차이무통계학의의(63.4％ vs.57.8％,P=0.506),균우우설하함복초분지평(63.4％ vs.33.3％,P=0.000;57.8％ vs.33.3％,P=0.001).오랍지이화초분지평적심뇌혈관병발증발생솔차이무통계학의의(6.9％vs.4.7％,P =0.345),균명현저우초산감유(24.4％ vs.6.9％,P=0.001;24.4％ vs.4.7％,P=0.000).결론 종합고필약물적료효화안전성,정맥주사오랍지이비설하함복초분지평화미량빙입초산감유경괄합APH적치료.
Objective To compare the clinical efficacy and safety of sublingual nifedipine,intravenous urapidil and micropump nitroglycerin in the treatment of APH (acute postoperative hypertension).Methods A retrospective study was conducted to analyze clinical data of 497 patients with AHP undergoing tumor resection from July 2007 through December 2010.Patients received antihypertensive treatment for APH; hypertension occurred within 24 hours after surgery; patients received no long-acting antihypertensive agents within 24 hours.Patients with a previous history of coronary heart disease,arrhythmia,stroke and incomplete clinical data were excluded.All patients were divided into three groups.Nifedipine group,10 mg nifedipine tablet was administered sublingually; urapidil group,12.5 mg of urapidil was diluted in 20 ml normal saline and administered by intravenous injection; nitroglycerin group,25 mg of nitroglycerin was diluted in 40ml normal saline and infused intravenously by a micropump.The x2 test was employed to compare the efficacy and safety among different treatment.Results Treatment with sublingual nifedipine caused a reduction of the systolic blood pressure by 5.8％,and diastolic blood pressure by 4.7％.Treatment with intravenous urapidil caused a reduction of the systolic blood pressure by 11.1％,and diastolic blood pressure by 8.4％.Treatment with micropump nitroglycerin caused a reduction of the systolic blood pressure by 13.1％,and diastolic blood pressure by 10.2％.There is not different between intravenous urapidil and micropump nitroglycerin (63.4％ vs 57.8％,P =0.506).Intravenous urapidil and micropump nitroglycerin were associated with a significantly higher rate of blood pressure control than sublingual nifedipine (63.4％ vs 33.3％,P =0.000; 57.8％ vs 33.3％,P =0.001).The frequency of cardio-cerebrovascular events in intravenous urapidil group was similar to that in sublingual nifedipine group (6.9％ vs 4.7％,P =0.345),but it was significantly higher in micropump nitroglycerin group compared with intravenous urapidil group and sublingual nifedipine group.(24.4％ vs 6.9％,P =0.001 ; 24.4％ vs 4.7％,P =0.000).Conclusions Considering therapeutic effect and safety,we concluded that intravenous administration of urapidil was more suitable for the treatment of APH compared with sublingual nifedipine and micropump nitroglycerin.
