【摘要】 目的:探讨Ⅱ期高血压病患者术前不同降压治疗时间麻醉诱导时心血管反应。方法:80例合并高血压病恶性肿瘤患者,分为4组,Ⅰ组,术前降压治疗大于4周;Ⅱ组,术前降压治疗2～4周;Ⅲ组,术前降压治疗1～2周;Ⅳ组,术前降压治疗<1周。以咪唑安定、依托咪酯、芬太尼和卡肌宁行麻醉诱导和气管插管,监测诱导期间无创血压(NIBP)、心率(HR)、心率收缩压乘积(RPP)、心电图(ECG)等的变化。结果:诱导后NIBP、HR、RPP显著降低,插管后1～3min NIBP、HR、RPP较诱导后显著升高,插管后3～5min又降至诱导后水平。组间比较,Ⅳ组各指标升高幅度显著大于Ⅰ、Ⅱ组。诱导后麻黄素和阿托品用量无显著差异。结论:高血压病患者麻醉诱导期间心血管反应明显,术前用降压药治疗2周以上的患者心血管反应较降压治疗不足1周的患者轻。更多还原

【Abstract】 Objective: To compare the cardiovascular responses to anesthesia induction in hypertensive patients, who were receiving anti-hypertensive therapy at different time. Methods: 80 cancer patients with hypertension were divided into four groups with 20 cases each. Group Ⅰwas treated with calcium channel blocker ≥ 4 weeks , groups Ⅱwas treated with the same drugs for 2~4 weeks, groups Ⅲwas treated with the same drugs for 1~2 weeks, groups Ⅳ was treated with the same drugs <1 week. Intubation were performed after induction with midazolam, propofol, fentanyl and atracuium. NIBP,HR,RPP and ECG were recorded during induction. Results: NIBP,HR and RPP decreased significantly after induction in both groups. NIBP,HR and RPP increased significantly immediately after tracheal intubation and persisted until at 3 min after intubation in both groups. The increase in NIBP,HR and RPP was significantly greater in group Ⅳ than that in groupⅠand Ⅱ. There were no significant differences between the four groups in anesthesia related hypotensive episodes and in the amount of ephedrine and atropine used. Conclusion:Cardiovascular responses to anesthesia induction in hypertensive patients are noticeable. Preoperative anti-hypertensive therapy≥ 2 weeks can decrease the fluctuation of blood pressure caused by tracheal intubation.更多还原