盐酸乌拉地尔治疗出血性脑卒中围手术期高血压的疗效观察

Observation on Therapeutic effect of Urapidil Hydrochloride in Control of Blood Pressure at the Perioperative Stage of Hemorrhagic Apoplexy

目的:观察盐酸乌拉地尔治疗出血性脑卒中围手术期高血压的疗效。方法:80例高血压脑出血患者术前均给予镇静、脱水、止血、营养脑神经等常规治疗,血压仍居高不下者,或插管后血压升高难以控制者,应用盐酸乌拉地尔250mg加入5%葡萄糖注射液250ml中,以输液泵持续恒速静脉滴注,初始速度2mg/min,同时监测心率和血压,根据血压情况10min～15min内调整输液速度一次,达到目标血压21.2/13.2kPa后改以维持剂量0.1～0.4mg/min治疗。记录给药前、给药2、5、10、15、20、30min及术后血压、心率变化。结果:给药5min,血压下降比较明显,未发生低血压,同时心率轻微增快,不超过10次/min。结论:盐酸乌拉地尔不增加心率,降压平稳、安全,剂量易控制。用于术中止血及血肿清除时血压平稳,减少了术中、术后因血压升高引起再出血的可能性。

OBJECTIVE:To observe the efficacy of urapidil hydrochloride in control of blood pressure at the perioperative stage of hemorrhagic apoplexy.METHODS:All80patients with hypertensive cerebral hemorrhage were managed with sedaˉtive,dehydration,hemostasis,and cerebral nerve nourishment,then when the blood pressure still remained high,or the blood pressure was hard to control after the intubation,urapidi hydrochloride was administered by intravenous infusion at the dose of250mg added with250ml of5%glucose infusion,the infusion drip was set at constant speed,with2mg/min as its starting speed,while at the same time the blood pressure and heart rate were monitored and infusion speed was adjusted every10to15min,after the target blood pressure21.2/13.2kPa was obtained,the infusion speed was kept at0.1～0.4mg/min.The blood pressure and heart rate were observed separately before the administration of urapidil hydrochloride and2,5,10,15,20and30min after the administration as well as after the operation.RESULTS:5min after the administration,blood presˉsure decreased remarkably but not to the extent to cause low blood pressure,and the heart rate increased slightly at the same time,generally not over10beats each minute.CONCLUSION:Urapidil hydrochloride decreases blood pressure steadily and safely at a manageable dosage.It can be used to control blood pressure during hemostasis and clearance of hematoma,which reduces the possibility of rehemorrhagia caused by high blood pressure during and after the operation.