经微量泵静脉注射硝普钠治疗高血压急症的疗效观察

Effect of intravenous nitroprusside sodium by minipump for hypertensive emergencies

目的:观察经微量泵静脉注射硝普钠治疗高血压急症的疗效。方法:高血压急症84例随机分为硝普钠治疗组(n=43)和硝酸甘油对照组(n=41),两组经微量注射泵持续给药,硝普钠组50mg加入5%葡萄糖50ml,0.25μg/kg.min开始,5min监测血压1次,据血压调整给药剂量;硝酸甘油组:硝酸甘油10mg加入5%葡萄糖48ml,10μg/min开始,据血压调整速度,观察头痛、胸闷、气促等不良反应,记录血压、心率、心电图等资料。结果:硝普钠组42例(97.7%)显效,1h内收缩压从治疗前的(203.3±15.5)mmHg降至(167.2±16.4)mm-Hg(P<0.05),舒张压也显著下降[(124.6±13.9)mmHg∶(103.0±15.8)mmHg,P<0.05];两组显效率有显著差异(97.7%∶82.9%,P<0.05)。结论:硝普钠治疗高血压急症更有效,经微量注射泵持续给药更安全。

Objective： To investigate the efficacy and safety of intravenous nitroprusside sodium by minipump for hypertensive emergencies. Methods： The 84 patients with hypertensive emergencies were randomly divided into two groups： Nitroprusside group [43 cases, received nitroprusside （initially 0.25μg/kg ·min, titrated with blood pressure） ] and nitroglycerin group ~41 cases, treated with nitroglycerin （initially 10μg/min, titrated with blood pressure）] . Two drugs were given intravenously by minipump. Such adverse reactions as headache, chest discomfort and dyspnea were observed. The arterial blood pressure, heart rate and electrocardiogram were recorded. Results： The excellence rate was 97. 7% （42/43） in nitroprusside group, it was significantly higher than that of nitroglycerin group （82.9%, P 〈0. 05）. In first h the systolic blood pressure significantly decreased from （203.3±15.5） mmHg to （167. 2±16. 4） mmHg （P〈0. 05）, diastolic blood pressure from （124.6±13.9） mmHg to （103. 0±15.8） mmHg （P〈0. 05） in nitroprusside group. Conclusion： Intravenous nitroprusside by minipump is saler and more effective for hypertensive emergencies.