硝酸甘油与拉贝洛尔联合应用于控制性降压与临床研究.docVIP

硝酸甘油与拉贝洛尔联合应用于控制性降压的临床研究 杨芳 董圣杰 张艳平 孙振海 【摘要】目的 观察硝酸甘油与拉贝洛尔联合应用的控制性降压效应。方法 60例ASAⅠ-Ⅱ级手术患者，全身麻醉下行颅脑肿瘤外科手术。所有患者随机分成3组，硝酸甘油组（Ⅰ组），硝酸甘油复合拉贝洛尔组（Ⅱ组），拉贝洛尔组（Ⅲ组），每组20例。术中监测和记录手术前、降压前、达到目标血压0min（T0）、5min（T1）） min后的MAPⅠ组恢复为降压前的102.4%，Ⅱ组恢复为降压前的98.8%，Ⅲ组恢复为降压前的96.3%，Ⅱ组比Ⅰ组、Ⅲ组升压过程平稳。结论 硝酸甘油与拉贝洛尔联合应用控制性降压可减少两者用量，低血压状态易维持，反射性心动过速和反跳性高血压发生率明显减少，复压过程平稳。 【关键词】硝酸甘油 拉贝洛尔 控制性降压 颅脑外科手术 The clinical observation of controlled-hypotension induced by combination of nitroglycerin and labetalol YANG fang,DONG sheng-jie,ZHANG yan-ping,SUN zhen-hai,Department of Anesthesiology,People’s hospital of Cangzhou,Cangzhou,061000 【abstract】Objective To investigate controlled-hypotension induced by combination of nitroglycerin and labetalol in crainocerebral operations.Methods Sixty ASAⅠorⅡ patients undergoing elective crainocerebral operrations were ----------------------------- 作者单位：河北省沧州市人民医院 061000 通信作者：杨芳 沧州市人民医院麻醉科 主治医师 邮编：061000 电话E-mail:yangfang2002727@ equally randomized into three groups to induce deliberate hypotension with nitroglycerin (Ⅰgroup),the combination of nitroglycerin and labetalol（Ⅱgroup） and labetalol（Ⅲgroup）. HR and MAP were monotored during operations.Results The blood pressure in group Ⅱ was more easy to control than in group Ⅰand Ⅲ.The dosage of nitroglycerin used in group Ⅱwas less than in group Ⅰ(P＜0.05). The dosage of labetalol used in group Ⅱwas less than in groupⅢ(P＜0.05).The process of blood pressure hoist in group Ⅱ, Ⅲ was more stable than in group Ⅰ.Conclusion controlled-hypotension induced by combination of nitroglycerin and labetalol could maintain stable hypotension,decress the dosage of nitroglycerin or labetalol,reduce the occurrence of reflex tachycardia and hypertension rebound during operations. 【Key words】nitroglycerin; labetalol; hypotension controlled; operations of crainocerebral 控制性降压可以减少手术出血和术中输血，使手术野清晰，利于手术操作。试用硝酸甘油与拉贝洛尔联和应用于颅脑外科手术中控制性降压，效果满意，报告如下： 资料与方法 一般资料 择期颅脑手术患者60例，ASAⅠ或Ⅱ级，男38例，女22例，年龄35~ 66岁,体重56~ 79㎏