国际医药卫生导报
國際醫藥衛生導報
국제의약위생도보
INTERNATIONAL MEDICINE & HEALTH GUIDANCE NEWS
2014年
21期
3305-3308
,共4页
高血压%全麻苏醒期%降压时机%乌拉地尔%血流动力学
高血壓%全痳囌醒期%降壓時機%烏拉地爾%血流動力學
고혈압%전마소성기%강압시궤%오랍지이%혈류동역학
Hypertension%Recovery period of general anesthesia%Decompression time%Urapidil%Hemodynamics
目的 探讨高血压(HTN)患者全麻苏醒期应用乌拉地尔降压的最佳时机.方法 对2009年3月至2013年4月在我院就诊的90例HTN患者的临床资料进行回顾性分析,根据随机数字表分组,每组30例,A组于气管拔管前5 min,B组于血压开始上升即刻,C组于脑电双拼指数(BIS)达70即刻,分别给予乌拉地尔降压,比较三组患者的心率(HR)、平均动脉压(MAP)波动趋势及心脑血管意外发生情况.结果 (1)组内比较:较之人手术室时(T.),三组用药后各时间点的HR均明显高,而A组用药10 min(T5)后、B组用药后1 min(L)的MAP均明显升高,差异有统计学意义(P＜0.05).组间比较:A组L后的MAP明显高于B组、C组,B组T3的MAP明显高于A组、C组,差异均有统计学意义(P＜0.05),而各时间点HR组间比较差异均无统计学意义(P＞0.05).(2)三组HTN患者全麻苏醒期心动过缓、心动过速、低血压、高血压等心脑血管意外事件发生情况组间比较,差异无统计学意义(P＞0.05).结论 在HTN患者全麻苏醒期,于BIS达70即刻予以乌拉地尔,不仅降压效果确切,血流动力学也更平稳,值得深究推广.
目的 探討高血壓(HTN)患者全痳囌醒期應用烏拉地爾降壓的最佳時機.方法 對2009年3月至2013年4月在我院就診的90例HTN患者的臨床資料進行迴顧性分析,根據隨機數字錶分組,每組30例,A組于氣管拔管前5 min,B組于血壓開始上升即刻,C組于腦電雙拼指數(BIS)達70即刻,分彆給予烏拉地爾降壓,比較三組患者的心率(HR)、平均動脈壓(MAP)波動趨勢及心腦血管意外髮生情況.結果 (1)組內比較:較之人手術室時(T.),三組用藥後各時間點的HR均明顯高,而A組用藥10 min(T5)後、B組用藥後1 min(L)的MAP均明顯升高,差異有統計學意義(P＜0.05).組間比較:A組L後的MAP明顯高于B組、C組,B組T3的MAP明顯高于A組、C組,差異均有統計學意義(P＜0.05),而各時間點HR組間比較差異均無統計學意義(P＞0.05).(2)三組HTN患者全痳囌醒期心動過緩、心動過速、低血壓、高血壓等心腦血管意外事件髮生情況組間比較,差異無統計學意義(P＞0.05).結論 在HTN患者全痳囌醒期,于BIS達70即刻予以烏拉地爾,不僅降壓效果確切,血流動力學也更平穩,值得深究推廣.
목적 탐토고혈압(HTN)환자전마소성기응용오랍지이강압적최가시궤.방법 대2009년3월지2013년4월재아원취진적90례HTN환자적림상자료진행회고성분석,근거수궤수자표분조,매조30례,A조우기관발관전5 min,B조우혈압개시상승즉각,C조우뇌전쌍병지수(BIS)체70즉각,분별급여오랍지이강압,비교삼조환자적심솔(HR)、평균동맥압(MAP)파동추세급심뇌혈관의외발생정황.결과 (1)조내비교:교지인수술실시(T.),삼조용약후각시간점적HR균명현고,이A조용약10 min(T5)후、B조용약후1 min(L)적MAP균명현승고,차이유통계학의의(P＜0.05).조간비교:A조L후적MAP명현고우B조、C조,B조T3적MAP명현고우A조、C조,차이균유통계학의의(P＜0.05),이각시간점HR조간비교차이균무통계학의의(P＞0.05).(2)삼조HTN환자전마소성기심동과완、심동과속、저혈압、고혈압등심뇌혈관의외사건발생정황조간비교,차이무통계학의의(P＞0.05).결론 재HTN환자전마소성기,우BIS체70즉각여이오랍지이,불부강압효과학절,혈류동역학야경평은,치득심구추엄.
Objective To discuss the best time of urapidil decompression in patients with hypertension during recovery period of general anesthesia.Methods A retrospective analysis was carried out to study the clinical data of 90 cases with hypertension from March 2009 to April 2013 in our hospital.And the cases were divided into three groups according to random number table,30 cases in each group.Group A was given urapidil step-down 5 min before tracheal extubation,group B was given urapidil stepdown blood pressure began to rise immediately,group C was given urapidil step-down electrical double index (BIS) of 70 immediately,three groups were compared in the patient's heart rate (HR),mean arterial pressure(MAP) fluctuation trend and heart cerebrovascular accident happening.Results (1) It did not show statistical significant differences between the three groups on general data of sex,age,weight,intraoperative blood loss and fluid volume (P ＞ 0.05),which was comparable.(2) Then we compared with the To (in the operation room),the HR of each time point in the three groups was significantly increased,the MAP in group A after administration of 10 min and in group B after administration of 1 min were significantly increased.Compared with those of group B and C,the MAP after T5 in group A was significantly increased.Compared with group A and group C,the MAP after T3 in group B was significantly increased.It showed statistical significant differences between them (P ＜ 0.05).There was no statistical significant differences about HR between each group at each time point (P ＞ 0.05).(3) It had no statistical significant differences about cardiovascular and cerebrovascular accident (bradycardia,sychnosphygmia,hypopiesia and hypertension) between the three groups (P ＞ 0.05).Conclusion Giving urapidil at BIS rose to 70 immediately in recovery period of general anesthesia,can significantly reduce blood pressure,ensure more stable hemodynamics,and it is worthy of further promotion.
