尼卡地平复合艾司洛尔对高血压患者气管拔管反应的影响

Nicardipine Composite Esmolol Influences Hypertension Patients at the time of Extubation

目的研究尼卡地平和艾司洛尔联合用药预防高血压患者气管拔管反应的效果。方法选择40例择期腹腔镜胆囊切除术合并高血压病史的患者,术毕具备拔管条件时随机分为对照组(A组)和观察组(B组),每组20例,拔管前A组静注等量生理盐水,B组静注尼卡地平0.02mg/kg和艾司洛尔0.1mg/kg,比较两组患者麻醉诱导前(T0)、用药后5min(T1)、拔管即刻(T2),拔管后5min(T3)和10min(T4)的收缩压(SBP)、舒张压(DBP)、心率(HR)变化。结果 T1与T0比较A组监测指标无明显变化,B组呈下降趋势,两组HR值差异有统计学意义(P<0.05);T2时段两组HR、SBP、DBP均上升,A组较B组升高幅度更大,监测值差异有统计学意义(P<0.05);T3、T4时段两组监测值均逐渐下降,SBP、DBP两组差异有统计学意义(P<0.05)。结论拔管前静注尼卡地平和艾司洛尔可有效抑制高血压患者拔管时不良心血管反应的发生。

Objective Through combining the treatment of the Nicardipine and Esmolol,study the effect on preventing the reaction of the patients with hypertension after tracheal extubation.Methods Meeting the requirement of tracheal extubation after operation,to patients undergoing elective laparoscopic cholecystectomy combined history of hypertension are randomLy picked out and divided into group A and group B,20 cases in each group.Before tracheal extubation,the patients from Group A are injected normal saline,while Nicardipine 0.02mg/kg and Esmolol 0.1mg/kg intravenous injections are given to the patients from group B.Compare all patients’ change of SBP,DBP,HR before anesthesia induction（T0）,drug taking within 5min（T1）,the moment after tracheal extubation（T2）,tracheal extubation within 5min（T3） and 10min（T4）.Results Comparing T1with T0,monitoring index from group A has no change,but group B is on the decline.The differences between the two groups has statistical significance（P0.05）.During T2,the HR、SBP、DBP of both groups are rising,which is much higher in group A than group B.Monitoring value difference is statistically significant（P0.05）;T3,T4 time monitoring value of both groups is gradually on the decline.Differences of SBP,DBP have statistical significance（P0.05）.Conclusion Nicardipine and Esmolol are given to the hypertension patients before tracheal extubation,it can effectively inhibit adverse cardiovascular reaction.