艾司洛尔复合硝酸甘油在鼻内窥镜手术中的应用.docVIP

艾司洛尔复合硝酸甘油在鼻内窥镜手术中的应用 广东省惠州市中心人民医院麻醉科 邹琦 【摘要】 目的　分析微量泵静脉注射硝酸甘油-艾司洛尔控制性降压在鼻内窥镜手术中的临床效果，为临床合理用药提供参考。方法 选择60例慢性鼻窦炎、鼻息肉且无控制性降压禁忌症的患者，随机分为对照组（A组），硝酸甘油组(B组)和艾司洛尔复合硝酸甘油组(C组)，每组20例。术中将B组和C组平均动脉压(MAP)降至基础值的60~70%(不低于46.5mmHg)，连续观察三组患者在手术过程中的出血量、手术时间、血压、心率变化。结果 与A组相比，B、C二组术中出血量明显减少(Ｐ0.05)，手术时间明显缩短(Ｐ0.05)， B组与C组相比，C组术中血压波动范围较小，停药后血压回升稳定，无反跳现象。与C组相比，A、B二组患者术中心率明显较C组快(Ｐ0.05)。结论：艾司洛尔复合硝酸甘油控制性降压用于鼻内窥镜手术,可防止降压过程中心率增快、停药后血压反射性增高，明显降低术中出血，缩短手术时间，有一定的临床应用价值。 【关键词】 艾司洛尔；硝酸甘油； 控制性降压 鼻内窥镜； The appliance of esmolol Nitroglycerin in nose endoscopy operation Zou qi，Zhang ying. Department of Anesthesiology,Huizhou municipal central hospital,Huizhou, Guangdong 516001,china 【Abstract】Objective To analyze the effect of deliberate hypotension by mainlining nitroglycerin-Esmolol with micro pump in endoscopic surgery and to provide reference for clinic. Methods Sixty patients undergone chronic nasosinusitis, rhinopolypus and had no deliberate hypotension contraindication were randomly divided into three groups: compared group（A group）, nitroglycerin group（B group）, nitroglycerin-Esmolol group（C group）（n=in each group）.In operation, reduce mean arterial pressure（MAP） of B group and C group to base data’s 60~70 percent（no less than 46.5ｍｍＨg) and continuously observe three groups’ patients’ bleeding during operation, operation time, blood pressure, heart rate change. Results Compared to A group, B group and C group have less bleeding during operation（Ｐ0.05） and their operation time is obviously shorten （Ｐ0.05).Compared to B group, C group’s blood pressure has a smaller fluctuating range and increase stably and never bounces after stopping taking medicine. Compared to C group, the heart rate of A and B’s patients is faster（Ｐ0.05). Conclusions Using nitroglycerin- Esmolol deliberate hypotension in endoscopic surgery can avoid the increase of heart rate in hypotension process, obviously decrease bleeding during operation and shorten operation time. 【Key words】Esmolol; Nitroglycerin; Del