尼卡地平静脉点滴用于妊娠期高血压急症紧急降压的疗效观察

The study of intravenous Nicadipine therapy in severe hypertension during pregnancy

目的 观察静脉用尼卡地平治疗孕期高血压急症的降压效果及对母婴的安全性。方法 观察16例妊娠期高血压急症病人接受静点尼卡地平治疗,心电监护仪观察24h动态血压、心率并评价其稳定性,电子监护仪监测胎心率用药前后变化,B超测定脐动脉血流S/D值并对新生儿进行Apgar评分、出生体重及新生儿预后的分析,了解其安全性。结果 全部患者静点尼卡地平后5～40min内血压可降至预期血压(140～150/90～100)mmHg,并能保持血压平稳。血压下降初始可伴心率加快,但多无症状,2h内即恢复。治疗前后胎心监护、胎儿脐血流无明显改变。结论 尼卡地平用于重度妊高症降压治疗是有效的,可平稳维持血压,未发现有严重不良反应,对胎儿安全性与其他钙拮抗剂相似。

Objective To assess the efficacy of Nicadipine therapy in severe hypertension disorder during pregnancy on decreasing blood pressure and the safety to mother and fetus.Methods 16 cases of severe hypertension during pregnancy were treated with intravenous Nicadipine. An automatic cardio - electric monitor record of blood pressure (BP) and heart rate (HR) was used continuously about 24 hours to assess the effect and stability of blood pressure. Fetal heart rate, ultrasonic S/D value of umbilical artery flows, Apgar scores, birth weight and newborn outcome were observed to evaluate the safety of nicadipine to fetus. Results all patients' blood pressure (Bp) were decreased to expected level (140 - 150/95-100(?)mHg) after intravenous infusion of nicadipine in 5 to 40 minutes. Heart rate was increased except one patient (6.25%) complained of palpitation but recovered in 2 hours. The fetal heart rates (FHR) were (143.73±8.16) bpm before treatment and (143.93±7.56) bpm after treatment (P = 0.93) .The UmAF S/D ratio was(3.32±2.36)before therapy and(3.00±2.01)after therapy( P = 0.34). The difference of FHR and UmAF S/D ratio was insignificant. No severe side effects were observed in pregnant women and fetus. Conclusions Nicadipine therapy in severe pregnancy induced hypertension is effective, and there is no severe side effects occurred. Its safety is similar to that of other calcium antagonists.