重症高血压静滴乌拉地尔后血压监测和效应分析

Monitoring blood pressure changes continuously in severe hypertension after intravenous urapidil

目的 :进一步研究重症高血压持续静脉滴注 (以下简称静滴 )乌拉地尔 (Urapidil)后的降压效应。 方法 :对4 3例重症高血压患者静脉注射 (以下简称静注 )乌拉地尔 2 5mg ,再以 5～ 10 μg/(kg·min)静滴 ,监测用药后即刻至4h的血压 ,观察相应的疗效和不良反应。 结果 :用药后 12 0min血压下降最明显并维持稳定 ,收缩压降至≤ 139mmHg、舒张压降至≤ 89mmHg者分别占 34.9%和 72 .1% ,用药后的症状明显缓解 ,7例患者有相关的不良反应。 结论 :对重症高血压用乌拉地尔首剂静注后再维持静滴是有效的治疗方法 ,对伴有心绞痛和心力竭衰者疗效肯定 ,不要求在急诊处理中将血压降至正常以下 ,用药过程中需监测血压。

Objective:To investigate blood pressure changes continuously in severe hypertension after intravenous urapidil. Methods: 43 patients were received a bolus dose of 25 mg urapidil,with 5-10 μg/(kg·min) intravenous drip 15 min later.Changes of blood pressure and symptoms were recorded until after 4 hrs. Results: The lowest blood pressure was found at 120 min and remained stablely,systolic and diastolic pressure well below 139 mmHg and 89 mmHg were achieved in 34.9%?72.1% of patients respectively.Symptoms were alleviated remarkably,especially in patients with heart failure and angina pectoris,adverse effects were observed in 7 patients. Conclusion:Intravenous urapidil is an effective choice in controlling severe hypertension particularly in patients complicated with cardiac failure and ischemia. A bolus dose of 10-25 mg and intravenous 5-10 μg/(kg·min) subsequently is recommended in practical use.Controlling of the pressure at standard level is unreasonable in emergency treatment and monitoring blood pressure should be emphasized during this process.