地尔硫(艹卓)与硝酸甘油在鼻内镜手术中控制性降压的疗效观察

摘要

目的:探讨地尔硫(艹卓)和硝酸甘油在鼻内镜手术中控制性降压的疗效.方法:60例择期鼻内镜手术患者随机分成3组,每组各20例,均采用气管内插管全麻.A组(n=20)无特殊处理,B组(n=20)硝酸甘油降压组,C组(n=20)地尔硫蕈降压组.观察各组麻醉前(T0)、控制性降压后10 min(T1)和30 min(T2)以及拔管即刻(T3)各时点的的心率(HR)、平均动脉压(MAP)和血乳酸含量(LA),术毕记录手术时间和出血量.结果:手术期间A组、B组HR明显高于C组,差异有统计学意义(P＜0.01),控制性降压后30min,B组和C组MAP均较A组低,差异有显著性(P＜0.01),手术期间B组、C组的出血量无明显差异,但都少于A组(P＜0.05),降压期间B组、C组的乳酸值升高无统计学意义(P＞0.05).结论:鼻内镜手术应用地尔硫革行控制性降压,效果显著,疗效确切,同时还有减慢心率、降低氧耗作用,优于硝酸甘油,可作为首选降压药.%Objective: To observe the effects of diltiazem and nitroglycerin in controlled hypotension during nasal endoscopic operations. Methods: Sixty patients undergoing nasal endoscopic operations were randomly divided into 3 groups, 20 cases in each group, received endotracheal intubation general anesthesia. Group A (n=20) received no special treatment, group B (n=20) received nitroglycerin to control blood pressure, group C (n=20) received diltiazem to control blood pressure. The heart rate (HR), mean arterial blood pressure (MAP), blood lactic acid, bleeding volume and time of operation were recorded. Results: The HR and MAP of Group A and Group B during operation were significantly higher than those in group C(P<0.01). At 30 min after controlled hypotension, the MAP of group B and C were significantly lower than that of group A (P<0.01). During the operation, the bleeding volumes of group B and group C showed no significant differences, but were smaller than that of group A (P<0.05). Conclusion: Diltiazem is better and safer comparing with nitroglycerin in controlled hypotension during nasal endoscopic operations. And it can slow down the heart rate to reduce oxygen consumption. It can be used as the first choice of antihypertensive agents during nasal endoscopic operations.