艾司洛尔复合硝酸甘油在高血压冠心病患者术中控制性降压的临床研究  

A clinic research of esmolol complex nitroglycen control depressor in the operation of the patients with coronary heart disease

作　　者：许雪梅[1] 林洁玲[1] 

机构地区：[1]湛江中心人民医院麻醉科,广东省湛江524037

出　　处：《中国基层医药》2007年第3期389-390,共2页Chinese Journal of Primary Medicine and Pharmacy

摘　　要：目的观察艾司洛尔复合硝酸甘油在高血压冠心病患者术中控制性降压与单纯硝酸甘油降压的效果。方法42例合并高血压冠心病择期行全髋关节置换术患者随机分为单纯硝酸甘油组（Ⅰ组）和艾司洛尔复合硝酸甘油组（Ⅱ组），每组21例。记录各组患者术中出血总量、输血总量、硝酸甘油用量，观察降压前（T0）、降压后10 min（T1）、降压后30min（T2）、降压后60min（T3）、停降压后60min（T4）的心率（HR）、平均动脉压（MAP）、心率-收缩压乘积（RPP）的变化。结果两组患者均能有效地控制性降压，术中出血量、输血量差异无统计学意义（P〉0．05），Ⅱ组硝酸甘油用量[（0．53±0．12）mg／kg]明显小于Ⅰ组（P〈0．01）。Ⅱ组患者在T1、T2、T3、T4时的心率变化比Ⅰ组明显降低（P〈0．01），RPP显著降低（P〈0．01）。结论艾司洛尔复合硝酸甘油用于高血压冠心病术中控制性降压，降压过程平稳，明显减少术中出血量和硝酸甘油用量，明显降低心肌耗氧量，是临床麻醉中一种有效、方便、安全的降压方法。Objective To observe the effect of esmolol complex nitroglycen between simplex nitroglycen in the operation of the patients with CHD. Methods 42 patients with CHD who would operate in metathesis of hip, were divide into two groups randomly, Ⅰ group（ n = 21 ） was simplex nitroglycen and Ⅱ group（ n = 21 ） was esmolol complex nitroglycen. Bleeding gross, blood filtering gross,hypertension dosage and the change of HR,MAP,RPP in T1, T2,T3, T4 were noted among all patients. Results All patients would be effective central blood pressure and had no difference in bleeding gross, blood filtering gross between the two groups（P 〉 0. 05）, hypertension dosage in Ⅱ group was less than Ⅰ group（P〈0.01）,HR change of Ⅱ group in T1 ,T2,T3 ,T4 was lower than Ⅰ group（P〈 0.01 ） ,RPP was decreased（P 〈 0.01 ）. Conclusion Esmolol complex nitorglycen use in control depressor in the operation of the patients with CHD,it is steady in depressor course, bleeding gross and hypertension dosage reduce in the operation,it can avoid HR expediting because of hypertension and can protect cardiac muscle. This way is effective, secure and convenient in clinic anaesthesia.

关 键 词：艾司洛尔 硝酸甘油 高血压 冠状动脉疾病 降压 控制性 

分 类 号：R54[医药卫生—心血管疾病] R6[医药卫生—内科学]