乌拉地尔对冠脉旁路移植术中血压升高的阻抑作用

Urapidil Inhibits Hypertensive Responses to Sternotomy and Sternal Closure

目的 探讨乌拉地尔对冠状动脉旁路移值术 (coronaryarterybypassgraft,CABG)开胸与关胸时血压升高的阻抑作用。方法 6 8例CABG手术 ,麻醉方法一致 ,随机、双盲分为实验组 (n =4 8)和对照组 (n =2 0 )。实验组在锯 撑开胸骨前及关胸骨前即刻分别注射乌拉地尔 0 .3mg/kg和 0 .2mg/kg ,对照组则在相应时间注射生理盐水 1 0ml。结果 在锯 撑开胸骨及关胸骨两个时段 :实验组血压较平稳 ,对照组血压明显升高 (P <0 .0 5 ) ;实验组ST段无明显变化 ,对照组ST段有明显下移 (P <0 .0 5 )。实验组经历了体外转流的病例中 ,有 5例在关胸骨期间收缩压一过性低于 1 2kPa ,经快速输血好转。结论 乌拉地尔能明显阻抑CABG术开胸与关胸时的血压升高 ,并稳定心电图的缺血改变。

Objective To observe inhibiting effect of urapidil on hypertensive responses to sternotomy and sternal closure.Methods 68 patients undergone coronary artery bypass graft (CABG) were randomly and double blindly divided into test group ( n =48) and control group ( n =20).Doses of 0.3 mg/kg or 0.2 mg/kg of urapidil and 10 ml normal saline were gave intravenously at the beginning of sternotomy and sternal closure,respectively,in each test group and control group.Results During the period of sternotomy and sternal closure,blood pressure was stabilized relatively in test group,but increased significantly in control group ( P <0.05);ST segments had no obvious change in test group,but had obvious changes in control group (P <0.05).In 5 patients systemic pressures were lower than 12 kPa and then resumed by transfusion quickly during sternal closure.Conclusion Urapidil can inhibit effectively hypertensive responses to sternotomy or sternal closure and prevent ischemic changes of ST segment of EKG in such circumstances.