广州医科大学学报

目的 :观察乌拉地尔 (URA)在颅脑手术中控制性降压的效果及优点。方法 :4 0例病人随机分为两组 :URA组 (I组 ,N =2 0例 )和硝酸甘油 (NTG)组 (Ⅱ组 ,N =2 0例 ) ,观察并比较两组降压时血流动力学、血气的变化。结果 :I组降压开始后HR逐渐减慢 ,降压中、降压后均维持在正常范围 (P >0 .0 5) ;Ⅱ组降压开始后HR突然增快 ,与I组比较有显著性差异 (P <0 .0 5)。I组降压后MAP波动幅度较小 ,降压较平稳 ;Ⅱ组MAP波动幅度较大 ,停降压后血压有反跳。I组降压时对血气影响较小 ,降压中 ,降压后BE轻度下降 ,PaCO2 轻度升高 ,与Ⅱ组比较有显著差异。结论 :乌拉地尔用于颅脑术中降压较NTG有明显优越性 ,心率不增快 ,血压无反跳现象 ,对PaO2 和PaCO2 无明显影响。

Objective:To compare the effects between urapdil (URA) and nitroglycerin(NTG) in controlled hypotension in brain surgery. Methods:40 patients were randomly divided into two groups:group URA (groupⅠ,n=20)and group NTG(groupⅡ,n=25). The changes of hemodynamics and blood gases during controlled hypotension were observed. Results: The HR in group Ⅰ slowed down eventually and remained in normal scope during and after hypotension,while the HR in group Ⅱincreased when controlled hypotension started, which was significant compared with that of group Ⅰ. During the controlled hypotension,MAP fluctuation in group Ⅰ was small,while it was larger in group Ⅱ with a MAP rebounding when controlled hypotension ended. There was a significant difference in the change of blood gases between two groups. Conclusion:URA is better than NTG in controlled hypotension for brain surgery.