探讨重度高血压伴心肌缺血行腹部急救策略

Discussion of Abdominal Emergency Strategy of Severe Hypertension with Myocardial Ischemia

目的探讨重度高血压伴心肌缺血行腹部急救的策略。方法分别在患者术毕拔管前和诱导插管前进行艾司洛尔及佩尔地平的静注,术中观察静滴硝基甘油及停药后三者的变化。观察患者舒张压(DBP),收缩压(SBP),心率(HR)的变化。结果术毕拔管前:静注药物后20min内,三项指标显著下降。诱导插管前:静注药物2min后,三项指标即已经显著下降,SBP、HR随后相继后回升至原水平。术中静滴硝酸甘油:SBP、DBP显著下降直至停药后30min,而整个过程中HR无显著变化。结论在高血压伴心肌缺血行腹部急救手术时,可以应用艾司洛尔、佩尔地平及硝基甘油来降低高血压,减缓心率增快。

Objective To explore the abdominal emergency strategy of severe hypertension with myocardial ischemia.Methods Induction before intubation and extubation,intravenous esmolol and Perdipine.Observe the change of systolic blood pressure（SBP）,diastolic blood pressure（DBP）,heart rate（HR）.Intraoperative,observation their changes of static drop nitrocellulose glycerin and stopped drug.Results Before intubation induction：Static note drugs after 2 min,three indicators have fallen significantly,SBP and HR come back to the original level later.Before extubation：Until intravenous drug after 20min,The three indicators decreased.Intraoperative static drop nitroglycerin：Static note drugs after 2 min,SBP,DBP decreased significantly until the withdrawal after 30min,HR didnt change significantly.Conclusion Having abdominal emergency surgery with hypertension and myocardial ischemia,we can use Perdipine、 esmolol and nitroglycerin to reduce high blood pressure,slow down the heart rate.