镁预处理对不稳定性高血压患者心脏术中血压的影响

Effect of Magnesium Pretreatment on Blood Pressure at Cardiac Surgery in Patients With Unstable Hypertension

目的:观察硫酸镁预处理对血压不稳定患者心脏手术中血压的影响。方法:未系统治疗高血压患者40例,随机分为两组:补镁组(20例)和对照组(20例)。切皮前取深静脉血测血镁水平。补镁组患者胸骨劈开前用硫酸镁40 mg/kg经深静脉注入再配合硝酸甘油和硝普钠进行降压治疗,对照组患者用硝酸甘油和硝普钠进行降压。记录和观察两组患者麻醉前、诱导、气管插管、切皮、劈胸骨、拧钢丝和缝皮时各时点的平均动脉压水平、血压波动值和硝酸甘油或硝普钠的平均用量。结果:补镁组与对照组比较在麻醉前、诱导、气管插管、切皮时平均动脉压、血压波动值和硝酸甘油、硝普钠用量差异均无统计学意义。补镁组与对照组比较在劈胸骨、拧钢丝、缝皮时的平均动脉压、血压波动值和硝酸甘油、硝普钠用量均降低,差异均有统计学意义(P<0.05)。结论:不稳定性高血压患者心脏手术中,劈胸骨前补充硫酸镁,可使患者血压更加平稳,并可减少降压药的用量。

Objective：To observe the effect of magnesium pretreatment on blood pressure at cardiac surgery in patients with unstable hypertension. Methods：Forty patients with unstable hypertension who underwent cardiac surgery were studied and randomly assigned into two groups,n = 20 in each group. Magnesium group, the patients received intravenous magnesium infusion at 40mg/kg with other vasodilator medication before the operation, and Control group, the patients received vasodilator medication without magnesium. We measured the baseline blood level of magnesium and recorded the mean arterial pressure （MAP） before ,during and after the car- diopulmonary bypass surgery in both groups. Results：All patients had high and unstable blood pressure before cardiopulmonary bypass. Before magnesium infusion, the fluctuation of MAP had no significant difference between two groups, P〉0. 05, while after magnesium infusion, compared with Con- trol group,more stable blood pressure was observed in Magnesium group,P〈0. 05. Conclusion：Magnesium pretreatment can stabilize blood pressure at cardiac sargery in patients with unstable hypertension and thereby reducing the vasodilator application for cardiac surgery.