摘要
目的:观察尼卡地平用于覆膜支架主动脉腔内修复术中控制性降压的效果,并与传统降压药物硝普钠进行比较。方法:选用40例Standford B型主动脉夹层拟经股动脉行覆膜支架主动脉腔内修复手术患者,随机分为尼卡地平(N)组和硝普钠(S)组。观察2组降压前、降压4 min和停止降压后10 min、20 min的心率(HR)、收缩压(SBP)、舒张压(DBP)、中心静脉压(CVP)和收缩压与心率乘积(RPP)的变化。结果:应用两种方法均呈现较明显的降压效果。与降压前比较,SBP、DBP明显下降(P<0.01),N组HR无显著变化,S组HR明显增快(P<0.05)。停止用药后,N组血压变化平稳,缓慢回升;S组有血压反跳现象(P<0.05)。降压4 min时,N组RPP明显下降(P<0.05),S组RPP无显著变化。CVP无显著变化。结论:尼卡地平用于夹层动脉瘤覆膜支架主动脉腔内修复术中的控制性降压作用迅速,用药后对心率无显著影响,其效果优于硝普钠,特别适用于伴有冠心病行主动脉夹层腔内修复术的患者。
Objective：To compare the efficacy and safety of nicardipine in controlled hypotension with sodium nitroprusside for patients undergoing endovascular stent-graft placement.Methods：Forty patients aged 39~71years old undergoing endovascular stent-graft placement for the treatment of Stanford B type aortic dissection were randomly divided into nicardipine（N） and sodium nitroprusside（S） groups.The diastolic blood pressure（DBP）,systolic blood pressure（SBP）,heart rate（HR） and central venous pressure（CVP） were recorded at following points： before controlled hypotension,4 min after infusion,10 min and 20 min after discontinuation of the infusion.In the same time,rate-pressure product（RPP） was calculated in every case.Results： A stable hypotensive state was rapidly achieved in 2 groups.SBP and DBP in both groups were significantly lower than those before infusion（P0.01）.There was reflex tachycardia during controlled hypotension in group S（P0.05）.There was rebound hypertension in group S after infusion was discontinued.Neither reflex tachycardia nor rebound hypertension were observed in group N.RPP during controlled hypotension decreased in group N,but did not changed in group S.There were no significant changes at every point regarding to CVP monitoring.Conclusion： Nicardipine is a safe,effective medication in controlled hypotension for patients undergoing endovascular stent-graft placement.it is a better medication than sodium nitroprusside,particularly in patients with coronary artery disease in clinical practice for the procedure of endovascular stent-graft placement.
出处
《心肺血管病杂志》
CAS
2012年第2期121-123,共3页
Journal of Cardiovascular and Pulmonary Diseases
关键词
尼卡地平
硝普钠
控制性降压
夹层动脉瘤
腔内修复
Nicardipine
Sodium nitroprusside
Controlled hypotension
Aortic dissection
Endovascular stent-graft placement
