静滴硝普钠对心衰患者血压的影响

Effect of sodium nitroprusside intravenous drip on blood pressure of patients with cardiac failure

目的 探讨静滴硝普钠治疗慢性心衰患者时血压下降幅度与滴速的关系。方法选择应用同样浓度、剂量硝普钠静滴治疗的慢性心衰患者 41例 ,在静滴过程中 ,每 1 5min由专人为患者测血压 1次 ,据血压下降幅度和患者症状随时调整滴速 ,保持血压平均下降 (1 .1 5±0 .0 2 )kPa。结果 患者对该药的耐受力有明显个体差异 ,持续静滴时间和患者体位的变化对滴速有影响。41例中 ,需要滴速 5滴 /min以下的 2例、6～ 1 0滴 /min的 2 9例、1 1～ 1 5滴 /min的7例、1 6滴 /min以上的 3例。结论 在静滴硝普钠治疗慢性心衰患者的过程中 ,应严密观察血压 ,及时调整滴速 。

Objective It is to explore the relationship between drop speed and drop of blood pressure during the treatment of chronic cardiac failure with sodium nitroprusside intravenous drip. Methods 41 patients with chronic cardiac failure treated with same concentration and dosage of sodium nitroprusside intravenous drip were studied. Blood pressure was monitored every 15 minutes. Drop speed was adjusted according to the drop of blood pressure and syndrome of patients to assure mean blood pressure drop within (1.15±0.02)kPa. Results The chronic cardiac failure patients’ tolerance for sodium nitroprusside intravenous drip has obvious individual difference. Drop speed was influenced by drop time and posture variation. In 41 patients the drop speeds of two patients were less than five drop/min, which of 29 patients were 6～10 drop/min, which of seven patients were 11～15 drop/min and which of three patients were more than 16 drop/min. Conclusion In order to assure safety and efficacy, blood pressure should be monitored strictly and drop speed should be adjusted immediately during the treatment of chronic cardiac failure with sodium nitroprusside.