尼卡地平与硝普钠在颅内动脉瘤手术中降压作用的对比观察

Observation and comparison on using perdipine and sodium nitroprusside to reduce blood pressure in cerebral aneurysm surgeries

关键词:  尼卡地平  硝普钠  动脉瘤  控制性降压

Key words:  perdipine  nitroprusside  aneurysm  controlled hypotension

摘要:

观察尼卡地平在颅内动脉瘤夹闭手术中的降压作用，并与硝普钠对比。［方法］ 26例择期颅内动脉瘤夹闭手术患者，随机分为硝普钠组（Ⅰ组）和尼卡地平组（Ⅱ组）。术中待手术需要降压时，用微量泵分别输注硝普钠和尼卡地平。对比观察降压期间血流动力学 变化和用药量。［结果］两组均达到满意的降压效果。两组MAP、HR无明显差异。Ⅱ组在应 用 降压药后血压缓慢上升，30 min内恢复到用药前水平，而Ⅰ组停药后5 min内恢复到用药前 水平，10 min后血压明显上升，两组差异明显(P<0.05)。尼卡地平用药量变动范围较大 。［结论］尼卡地平降压迅速平稳，停用后血压上升无反跳，并可预防脑血管痉挛。其不足之处 血压回升缓慢和用药量个体差异较大

Abstract:

To observe the effectiveness of using Perdipine to bring down blood pressure in Cerebral Aneurysm Excision Surgeries, and compare its effe ctiveness in relation to Nitroprusside. ［Methods］ Randomly divide 26 patients wh o were to receive the above surgeries on a set date into a Perdipine Group (Grou p I) and a Nitroprusside Group (Group II). When blood pressure reduction was req uired during surgery, Perdipine and Nitroprusside were injected respectively wit h syringe pumps. Observations and comparisons were made on the changes in haemod ynamics and dosage required during the process. ［Results］ Both groups achieved s atisfactory blood pressure-reduction results. No obvious differences were identi fied in MAP and HR of the two groups. After administering blood pressure-reducti on medication, blood pressure of Group II rose slowly to the level before surger y within 30 minutes' time whilst blood pressure of Group I bounced back to the l evel before operation within five minutes' time and blood pressure saw obvious i ncrease after 10 minutes. This indicated that obvious differences existed betwee n the two groups (P<0.05). The dosage required when administering Perdipine saw wide variations. ［Conclusions］ Perdipine is efficient and stable in reducing b loo d pressure and blood pressure does not bounce back after suspension of medicatio n, and cerebral blood vessel spasm can be prevented as well. Its drawback is the slowness for blood pressure to return to normal level and the wide individual v ariations in dosages required