鼻内镜手术中复合控制性降压的临床效果观察

Clinical effect observation of compound controlled hypotension in nasal endoscopic surgery

目的观察鼻内镜手术中复合控制性降压的临床效果。方法选取2011年3月～2012年9月在深圳市龙岗区第二人民医院接受鼻内镜手术的120例患者，将其分为对照组和观察组，每组各60例。手术过程中，未给予对照组患者任何降压措施；而给予观察组患者静注20mg乌拉地尔，并持续泵入25mg。记录两组手术时间、术后恢复清醒时间、术中出血量、血红蛋白（Hb）含量及ST段的变化情况。术后24h，对两组患者的肾功能指标进行随访。结果观察组患者在手术时间、术中出血量、Hb含量方面明显优于对照组（P〈0．05）；而在ST段变化、术后清醒时间及术后肾功能方面，两组差异无统计学意义（P〉0．05）。结论只要关注治疗的合理性和规范性。在鼻内镜手术中运用麻醉药物联合血管扩张药具有积极的意义，值得临床推广应用。

Objective To observe the clinical effects of compound controlled hypotension in nasal endoscopic surgery. Methods A total of 120 patients who received nasal endoscopic surgery in the Second People＇s Hospital in Longgang District of Shenzhen City from March 2011 to September 2012 were selected and divided into the observation group and the control group, with 60 patients in each group. During surgery, no depressurization measures were given to the patients in the control group, but intravenous injection of 20 mg of Urapidil was given to the patients in the observa- tion group and 25 mg was pumped in continuously. The operative time, postoperative recovery and sober time, blood loss, Hb content and changes in ST segment were recorded. The kidney function indicators of the two groups were fol- lowed up 24 h after the surgery. Results The observation group was significantly superior to the control group in the operative time, blood loss and Hb content （P 〈 0.05）. The two groups were not significantly different in the changes of ST segment, postoperative sober time and postoperative renal function （P 〉 0.05）. Conclusion As long as the rationality and normativity of treatment is guaranteed, the application of narcotic drugs combined with vasodilators has positive significance and its worthy of clinical application.