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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 observe the effect and advantage of Urapidil controlled hypotension in craniocerebral surgery. Methods: Forty patients were randomly divided into two groups: URA group (group I, N = 20) and NTG group (group Ⅱ, N = 20) Hemodynamics, blood gas changes. Results: After the start of antihypertensive treatment, the HR of group I was gradually decreased, and the normal range was maintained after antihypertensive and antihypertensive treatment (P> 0.05). The HR of group Ⅱ increased suddenly after the start of antihypertensive treatment, Significant difference (P <0. 05). In the I group, the amplitude of MAP fluctuated less after the depressurization, and the depressurization was more stable. In the Ⅱ group, the amplitude of the MAP fluctuated greatly, and the blood pressure rebounded after depressurization. In group I, blood pressure was less affected when blood pressure was depressurized. During depressurization, BE decreased slightly and PaCO2 increased slightly after depressurization, which was significantly different from that of group II. Conclusion: Urapidil is superior to NTG in lowering blood pressure in craniocerebral surgery, heart rate does not increase, blood pressure does not rebound phenomenon, and has no obvious effect on PaO2 and PaCO2.