高血压患者麻醉用药以及处理.docVIP

PAGE \* MERGEFORMAT 211 PAGE \* MERGEFORMAT 2 1 1 高血压患者麻醉用药及处理 摘要：随着社会老龄化的加重， 高血压已经变成麻醉医师每天遇到的问题之一, 对高血压病人围术期生理功能的变化规律、相应的麻醉方法和麻醉用药以及麻醉调控措施的研究正日益受到麻醉医师的重视。 高血压患者术前一定要加以治疗和控制, 适当地控制血压可使围术期心脑血管事件的发生明显减少。因此, 术前重视对高血压的明确诊断与合理有效治疗, 不仅可控制血压的水平, 改善代谢的紊乱, 预防和逆转靶器官的重构,而且对高血压病人顺利渡过围术期起着重要作用[1] 。临床资料显示，高血压病人术前对血压的治疗和控制，能够有效减少围术期心脑血管事件的发生( 尤其心脑血管意外事件的发生)，而未控制的高血压是麻醉手术的危险因素之一[2]。 关键词：高血压患者；围术期；麻醉用药；麻醉处理 Abstract: With the aging of society increased, hypertension has become one of the problems encountered by anesthesiologists daily variation of hypertensive patients undergoing surgery of physiological functions, research being appropriate method of anesthesia and anesthetic and narcotic control measures growing importance of anesthesiologists. Preoperative hypertensive patients must be treated and controlled appropriately controlled blood pressure can occur perioperative cardiovascular events significantly reduced. So, pay attention to the preoperative diagnosis of hypertension and reasonable and effective treatment, not only can control the level of blood pressure, improve metabolism disorders, prevention and reversal of target organ reconstruction, but also for patients with hypertension plays smoothly through the perioperative period important role [1]. Clinical data show that the first surgery on blood pressure in patients with hypertension treatment and control, can effectively reduce the incidence of perioperative cardiovascular events (especially cardiovascular and cerebrovascular accident occurred), without control of high blood pressure is a risk of anesthesia one of the factors [2]. Key Words:Hypertensive patients; perioperative; anesthetic; anesthesia process 1 高血压患者术前评估 对于高血压患者，手术前应通过全面检查明确是原发性高血压还是继发性高血压，了解高血压病期和进展情况，以及高血压程度，有无重要器官受累情况，是否合并其他疾病，了解用药治疗情况 [3]。 2 　高血压患者的术前准备 关于手术前是否应停用抗高血压药的问题, 长期以来一直存有争议。实践证明, 术前停用抗高血压药物, 血压可严重升高, 以致可能并发心肌梗死、心力衰竭、脑血管意外等。 PAGE \* MERGEFORMAT 3 PAGE \* MERGEFORMAT 3 所以主要的问题是应该加强麻