盐酸乌拉地尔控制老年高血压患者拔牙术中血压升高的疗效

Effects of urapidil hydrochloride on significant increase of blood pressure during dental extraction in aged patients with hypertension

目的:评价高血压患者拔牙术中出现血压明显升高时给予静脉注射盐酸乌拉地尔控制血压的疗效。方法:选择60例拔牙术中血压明显升高的高血压患者,随机均分为观察组和常规治疗组,观察组予静脉注射乌拉地尔,常规治疗组静脉点滴硝酸甘油,分别比较两组在5 min、10 min、20min和30 min时的降压有效率和心率的变化以及出现头痛的病例数,并进行统计学分析。结果:观察组在治疗5 min、10 min、20min和30 min时的降压有效率分别与常规治疗组的无显著差异(P>0.05),观察组各时间点心率均明显低于常规治疗组[5min(81.8±12.3)次/min∶(92.3±14.5)次/min,10min(84.0±12.1)次/min∶(94.4±13.4)次/min,20min(81.9±12.3)次/min∶(92.4±11.9)次/min,30min(81.6±12.3)次/min∶(89.4±11.2)次/min,P均<0.05];术中观察组头痛发生率显著低于常规治疗组(3.3%∶20%,P<0.05)。结论:拔牙术中血压明显升高时静脉注射乌拉地尔降压起效快,和静脉点滴硝酸甘油比较对心率影响较小,头痛发生率较低,值得推广。

Objective： To evaluate the therapeutic effects of intravenous injection of urapidil hydrochloride on significant increase of blood pressure during dental extraction in aged patients with hypertension. Methods： A total of 60 aged patients with hypertension whose blood pressure significantly increased during dental extraction were randomly and equally divided into observation group （received intravenous injection of urapidil） and routine treatment group （received intravenous drip of nitroglycerin）. Effective rates of lowering blood pressure, changes of heart rate and numbers of cases with headache of the two groups at 5min, 10min, 20min and 30min were compared and analyzed statistically. Results： There were no significant difference between the two groups in effective rates of lowering blood pressure at 5min, 10min, 20min and 30min （P〉0.05）. Heart rate at each time point in observation group was significantly lower than that of routine treatment group ESmin： （81.8±12.3） times/min vs. （92.3 ±14.5） times/min, 10min： （84.0± 12. 1） times/min vs. （94.4± 13.4） times/min, 20min： （81.9 ± 12.3） times/min vs. （92.4 ± 11.9） times/min, 30min： （81.6±12.3） times/min vs. （89.4±11.2） times/min, P〈0.05 all]. Number of cases with headache during operation in observation group was significantly lower than that of routine treatment group （3.3% vs. 20%, P〈 0.05）. Conclusion： When blood pressure significantly increases during dental extraction, intravenous injection of urapidil could quickly lower blood pressure; compared with intravenous drip of nitroghycerin, intravenous injection of urapidil has fewer effects on heart rate and lower incidence rate of headache, may be to spread.