摘要
目的 :观察压宁定对硝普钠控制性降压效应及血浆内分泌激素的影响 ,探讨两药复合应用的可行性 ,为临床合理选用降压药提供参考。 方法 :择期全麻下颅脑手术病人 2 8例 ,ASA ～ 级 ,随机分为硝普钠 ( 组 ,14例 )和压宁定复合硝普钠 ( 组 ,14例 )两组。两组病人麻醉诱导和维持方法相同 ,平均动脉压均降低 30 %～40 % ,分别于降压前即刻、降压达预计值时、维持降压 30 min、停降压 10 min时观察降压诱导时间和降压药的用量 ,监测血流动力学指标 ,测定血浆肾素活性、血管紧张素 、醛固酮和心钠素的水平。 结果 : 组降压诱导时间和降压药用量明显低于 组 (P <0 .0 5 ) ; 组降压后心率 (HR)明显增快 ,降压期间出现快速耐药性 ,停降压后出现反跳性高血压 ,与 组比较有显著性差异 (P <0 .0 5 ) ;两组病人各时点所测肾素活性、血管紧张素 、醛固酮和心钠素水平与降压前相比有显著性差异 (P <0 .0 1) ,但组间比较无统计学意义。结论 :压宁定复合硝普钠控制性降压 ,在一定程度上优于单纯硝普钠降压。
Objective: To observe the effects of urapidil on nitroprusside induced hypotension and plasma endocrine hormone. Methods: Twenty eight adult patients,ASA Ⅰ Ⅱ,scheduled for elective craniotomy,were randomly divided into two groups: Group Ⅰwith intravenous nitroprusside infusion(n=14),group Ⅱ with intravenous urapidil and nitroprusside infusion(n=14). The MAP was decreased by 30%～40%, and kept this lower level. The plasma renin activity (PRA), angiotensin Ⅱ(AⅡ), aldosterone (ALD) and atrial natriuretic polypiptide (ANP) levels and hemodynamics were measured at pre hypotension,immediately after hypotension, 30min following hypotension and 10min after discontinuation of sodium nitroprusside respectively. Results: As compared with those in groupⅠ, the blood pressure was more easily reduced and maintained,sodium nitroprusside dosage decreased by 65.5% in group Ⅱ . The reflex heart rate augmentation was suppressed,after the discontinuation of drug. The blood pressure increased steadily, and no rebounding response was observed and rate pressure product (RPP) value decreased significantly compared with that in groupⅠ(P<0.05). The levels of PRA, AⅡ,ALD and ANP both group were not significantly different (P>0.05) at various measurement time. Conclusion: The combination of urapidil and nitroprusside for controlled hypotension is an effective method,which can enhance the actions of nitroprusside and reduce its side effects.
出处
《新疆医科大学学报》
CAS
2000年第3期221-224,共4页
Journal of Xinjiang Medical University
关键词
控制性降压
压宁定
硝普钠
内分泌激素
hypotension, controlled
nitroprusside
urapidil
hemodynamics
endocrine hormone
