尼卡地平联合艾司洛尔控制性降压在颈内动脉内膜剥脱术中的应用效果研究  

Study on application effect of nicardipine combined with esmolol in controlled hypotension during carotid endarterectomy

作　　者：陈伟 许鹏 李凤利 CHEN Wei;XU Peng;LI Feng-li(Neurosurgery Department,Linyi Central Hospital,Linyi 276400,China;不详)

机构地区：[1]临沂市中心医院神经外科,276400 [2]临沂市中心医院麻醉科,276400

出　　处：《中国实用医药》2023年第24期21-25,共5页China Practical Medicine

基　　金：艾司洛尔联合卡地平在颈内动脉内膜剥脱术围术期控制性降压的临床应用价值(项目编号:TXHA2022ZX02105)。

摘　　要：目的分析在颈内动脉内膜剥脱术中选择尼卡地平联合艾司洛尔控制性降压的效果。方法选取50例需要采取颈内动脉内膜剥脱术治疗的颈动脉狭窄患者作为研究对象,按照随机数字表法分为观察组和对照组,每组25例。观察组患者术中采用尼卡地平联合艾司洛尔进行控制性降压,对照组患者术中采用艾司洛尔进行控制性降压。比较两组不同时间段[监测并记录入室(T0)、手术开始后10 min(T1)、阻断颈动脉时(T2)、控制性降压后1 min(T3)、控制性降压后5 min(T4)及控制性降压后15 min(T5)]的血压(舒张压和收缩压)水平,不同时间段的心率、心脏指数、额部局部脑氧饱和度(rSO2)水平,手术时间、失血量与颈动脉阻断时间。结果T0、T1时,两组收缩压和舒张压水平比较差异无统计学意义(P>0.05)。T2、T3、T4、T5时,观察组患者的收缩压和舒张压水平均低于对照组,差异具有统计学意义(P<0.05)。T0、T1时,两组患者的心率、心脏指数、rSO2水平比较差异无统计学意义(P>0.05)。T2、T3、T4、T5时,观察组患者的心率分别为(80.26±3.51)、(76.29±5.13)、(74.23±3.95)、(75.16±3.33)次/min,心脏指数分别为(3.25±0.08)、(3.19±0.05)、(3.15±0.06)、(3.14±0.05)L/(min·m2),rSO2分别为(70.16±3.68)%、(64.28±3.46)%、(61.28±3.54)%、(62.39±4.16)%;T2、T3、T4、T5时,对照组患者的心率分别为(85.23±3.51)、(84.13±5.16)、(80.16±3.64)、(81.25±3.79)次/min,心脏指数分别为(3.31±0.05)、(3.32±0.04)、(3.34±0.05)、(3.25±0.08)L/(min·m2),rSO2分别为(75.16±3.25)%、(74.16±3.61)%、(71.25±4.56)%、(69.85±3.68)%。T2、T3、T4、T5时,观察组患者的心率、心脏指数、rSO2水平均低于对照组,差异具有统计学意义(P<0.05)。两组手术时间、失血量比较差异无统计学意义(P>0.05);观察组颈动脉阻断时间(2.23±0.25)min显著短于对照组的(3.25±0.11)min,差异具有统计学意义(P<0.05)。结论在颈内动脉内膜剥脱�Objective To analyze the effect of nicardipine combined with esmolol in controlled hypotension during carotid endarterectomy.Methods A total of 50 patients with carotid stenosis requiring carotid endarterectomy were divided into an observation group and a control group according to random numerical table,with 25 cases in each group.The observation group was treated with nicardipine and esmolol for controlled hypotension,and the control group was treated with esmolol for controlled hypotension.Both groups were compared in terms of blood pressure(diastolic blood pressure and systolic blood pressure)levels at different time periods[before induction of anesthesia(T0),10 min after surgery(T1),carotid artery occlusion(T2),1 min after controlled hypotension(T3),5 min after controlled hypotension(T4)and 15 min after controlled hypotension(T5)],heart rate,cardiac index,regional cerebral oxygen saturation(rSO2)level at different time periods,operative time,blood loss and time of carotid artery occlusion.Results At T0 and T1,there was no statistically significant difference in systolic blood pressure and diastolic blood pressure between the two groups(P>0.05).At T2,T3,T4 and T5,the systolic and diastolic blood pressure levels in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).At T0 and T1,there were no statistically significant differences in heart rate,heart index and rSO2 levels between the two groups(P>0.05).At T2,T3,T4 and T5,the heart rate of the observation group were(80.26±3.51),(76.29±5.13),(74.23±3.95)and(75.16±3.33)beats/min,the cardiac index were(3.25±0.08),(3.19±0.05),(3.15±0.06)and(3.14±0.05)L/(min·m2),and rSO2 were(70.16±3.68)%,(64.28±3.46)%,(61.28±3.54)%and(62.39±4.16)%.At T2,T3,T4 and T5,the heart rate of the control group were(85.23±3.51),(84.13±5.16),(80.16±3.64)and(81.25±3.79)beats/min,the cardiac index were(3.31±0.05),(3.32±0.04),(3.34±0.05)and(3.25±0.08)L/(min·m2),and rSO2 were(75.16±3.25)%,(74.16±3.61)%,

关 键 词：尼卡地平 艾司洛尔 颈内动脉内膜剥脱术 控制性降压 

分 类 号：R651.12[医药卫生—外科学]