高血压拔牙患者控制性降压的随机双盲临床研究  

Oral medication controlled hypotension in hypertensive patients before tooth extraction:A randomized double-blinded clinical study

作　　者：侯锐 吴芳 何黎升 张林林 刘卓 

机构地区：[1]第四军医大学口腔医院口腔颌面外科,陕西西安710032

出　　处：《中国口腔颌面外科杂志》2014年第1期51-55,共5页China Journal of Oral and Maxillofacial Surgery

摘　　要：目的:比较高血压患者拔牙术前口服不同药物控制性降压前、后血压和心率的变化,探讨有效控制患者围术期血压的用药方法。方法:对90例高血压拔牙患者随机使用不同药物,即安定、硝苯地平或安定及硝苯地平联合应用,术前进行药物控制性降压,记录拔牙前、后血压、心率变化,采用SPSS17.0软件包,对不同药物的降压效果及拔牙复杂程度、拔牙时间对血压、心率的影响分别进行t检验和χ2检验。结果:经药物控制性降压后,高血压患者拔牙期间血压、心率较平稳,安定与硝苯地平联合应用的降压有效率最高(96.7%)。拔牙难度和拔牙时间对单纯应用安定及安定与硝苯地平联合应用组患者拔牙期血压的变化影响较小,而对单纯应用硝苯地平组患者影响大,但对各组心率均无显著影响。结论:术前药物控制性降压能够达到良好的降压效果,联合用药能更好地提高高血压患者拔牙的安全性。PURPOSE： To compare the changes of blood pressure and heart rate in patients with hypertension who took different oral medications to control hypertension before tooth extraction and to find a way to better control hypertension around tooth extraction. METHODS： Ninety patients with hypertension undergoing controlled hypotension medication were given three different drugs randomly, including diazepam, nifedipine and diazepam combined with nifedipine. Blood pressure and heart rate during extraction were recorded in detail. The data was analyzed with SPSS17.0 software package for either t test or Chi-square test. RESULTS： Changes of perioperative blood pressure and heart rate was relatively stable after controlled hypotension medication. Difficulty and time during tooth extraction were charged slightly in both diazepam group and diazepam combined with nifedipine group, but significantly in nifedipine group. There was no significant change in heart rate in all groups. CONCLUSION： Controlled hypotension by oral medication before extraction could lower the blood pressure well. Combined medications can better ensure the safety of patients with hypertension during tooth extraction.

关 键 词：高血压 拔牙 控制性降压 

分 类 号：R544.1[医药卫生—心血管疾病] R782.1[医药卫生—内科学]