硝普钠在高血压脑出血术中的降压及脑保护作用

Antihypertension and protection of SNP on brain at peri-operative duration for hypertension patients with bleeding

目的探讨硝普钠在高血压脑出血围术期的降压及脑保护作用。方法选择高血压脑出血患者56例,分为硝普钠组(36例)和对照组(即硝酸甘油组,20例)。对两组患者围术期的平均动脉压、心率、颈内静脉血氧饱和度及术后病死率进行对比观察。结果硝普钠组患者用药后的平均动脉压、心率、颈内静脉血氧饱和度均比术前明显改善,而硝酸甘油组则改变不明显;硝普钠组患者术后病死率比硝酸甘油组明显下降。结论硝普钠具有降低外周血管阻力、减轻心脏前负荷、降低左室充盈压及改善心功能的作用,且不降低心输出量,从而纠正全身各重要脏器的缺血、缺氧状况,并且静脉滴注给药可使降压幅度平稳且复压迅速;术中连续应用硝普钠对神经胶质细胞具有延迟保护作用,因此,硝普钠对高血压脑出血患者具有较好的降压及脑保护作用,并能降低该类患者术后的病死率。

Objective To investigate the effects of the (Sodium Nitroprusside) SNP in antihypertension and pretecting brain at perioperative duration for patient with bleeding in brain caused by hypertension. Method The 56 patients divided into two groups random the SNP group (36 patients) and the NTG group (20 patients). The HR,MAP,SjVO2 were measured at perioperative duration, and mortality after operation was calculated. Result After used drug, the patients in the SNP group had a great improvemen in HR, MAP, SjVO2, but the changes in the NTG group had no evidence. The mortality in the SNP group had greatly be reduced than in the NTG group. Conclusion SNP has the effect of depressing resistance of exterior vas, alleviating pre-load of heart, decreasing exuberate pressure in left ventricle, improving heart function without lowering of cardiac output, thus improving ischemia and anoxia in important organs of body, and the range of depressing pressure is windless, recovery of pressure is rapidly. Application of SNP in the operation seriate can make protein S100 release reduced, and then to protect the glia cell postponly. SNP has a good effect in antihypertension and pretecting brain tissue at perioperative duration for patient with bleeding in brain caused by hypertension.