【摘要】 目的比较鼻内镜手术中应用尼卡地平、硝普钠行控制性降压对脑氧代谢的影响。方法选择鼻息肉行内镜手术者30例,随机分为两组,分别采用尼卡地平(A组,n=15)和硝普钠(B组,n=15)行控制性降压。于不同时段降压前(T0)、降压后10 min(T1)、降压后30 min(T2)及停止降压后10 min(T3)行动静脉血气分析。结果①T1、T2时,B组HR明显快于T0时,且在此两时点HR明显快于A组(P<0.05)。②A组D(a-jv)O2、CERO2在T1、T2时较T0时明显下降,且在此两时点上明显低于B组(P<0.05)。结论尼卡地平、硝普钠均可安全用于鼻内镜手术中的控制性降压,都能降低脑氧代谢,但在降低脑氧代谢、改善脑氧合方面,尼卡地平优于硝普钠,有较好的脑保护作用。更多还原

【Abstract】 Objective To compare the effects of nicardipine with sodium nitroprusside on cerebral oxygen metabolism in controlled hypotension during endoscopic sinus surgery(ESS).Methods 30 patients suffered nasal polyps were randomly divided into group A and group B,with 15 cases for each.Nicardipine was administered to group A and sodium nitroprusside to group B.Blood gas analysis of arterial and jugular bulb venous blood samples were performed before(T0),10 minutes(T1) and 30 minutes(T2) after deliberate hypotension induced,and 10 minutes(T3) after discontinuation of hypotension.The cerebral arteriovenous differences were calculated in oxygen content [D(a-jv)O2] and cerebral oxygen extraction rate(CERO2).Results Both heart rate of T1 and T2 were significantly higher than those of T0 in the group B,and were also obviously higher than those of group A(P<0.05).Both D(a-jv)O2 and CERO2 of T1 and T2 were significantly lower than those of T0 in the group A,and were obviously lower too than those of group B(P<0.05).Conclusion During ESS,both nicardipine and sodium nitroprusside are safe and effective to induce deliberate hypotension by reducing cerebral metabolism and improving oxygenation,but nicardipine extends more important value than sodium nitroprusside in cerebral protection.更多还原