高血压患者拔牙术前口服药物控制性降压263例回顾性分析

Oral medication controlled hypotension in hypertensive patients before tooth extraction:A retrospective review of 263 cases

目的:回顾原发性高血压患者拔牙术前口服药物控制性降压前后血压和心率变化,探讨口服药物降低患者血压的有效性,从而提高高血压患者拔牙的安全性。方法:对1997年1月～2011年12月就诊的263例高血压拔牙患者,在分别服用安定、硝苯地平等药物及联合用药进行控制性降压后,将患者的临床资料根据高血压级别、性别和年龄进行回顾性统计分析。结果:术前药物控制性降压患者人数逐年增多。各组用药前后血压变化均有统计学意义。安定和安定联合硝苯地平降压作用良好,其中安定在高血压3级、男性和超过75岁的患者中降压效果明显;而安定联合硝苯地平在高血压2级、3级,女性和超过75岁的患者中降压效果明显,其差别均有统计学意义。单纯应用硝苯地平降压有效率最低。结论:术前药物控制性降压能够达到良好的降压效果,可有效提高高血压患者拔牙安全性。

Objective To review the changes in blood pressure and heart rate in patients with hypertension who took oral medications to control hypertension before tooth extraction.Whether oral medications can safely reduce blood pressure was also discussed.Method：The blood pressure of 263 patients with hypertension was controlled by different oral medication from January 1997 to December 2011 in our department.The data were collected and the statistical analysis was made on blood pressure level,gender and age.Result：The number of patients undergoing controlled hypotension was increasing year by year.The changes on blood pressure in each group were statistically significant after the medication.Diazepam and combined application of nifedipine and diazepam had good antihypertensive effect.The difference was statistically significant in patients of hypertension 3-class,men and over 75-year-old in diazepam group and in patients of hypertension 2,3-class,female and over 75-year-old in combined application of nifedipine and diazepam group.Efficient of simple application of nifedipine was the lowest.Conclusion：Controlled hypotension by oral medication before extraction could lower the blood pressure effectively so as to improve the safety of the extraction.