硝普钠与硝酸甘油治疗高血压急症疗效观察(1)
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【摘要】 目的 观察硝普钠与硝酸甘油治疗高血压急症的降压效果，评价其疗效和安全性。方法 30例高血压患者随机分成两组，一组持续静脉泵入硝酸甘油，另一组持续泵入硝普纳作为对照，监测血压，观察两组治疗效果，分别记录用药前后血压，心率及临床表现的变化，同时了解达到治疗高血压急症的最初目标。结果 硝普钠与硝酸甘油均可显著降低高血压急症患者的血压，两组在降压效果上比较，差异无统计学意义(P>0.05)；在降压过程中心率的变化差异有统计学意义(P<0.05)。结论 采用静脉滴注硝酸甘油治疗高血压急症，操作简单方便，疗效满意，当为首选。
【关键词】高血压急症；硝普钠；硝酸甘油；治疗
The effect of Sodium Nitroprusside and Nitroglycerin treatment of hypertensive emergencies
WANG Guang-jun. The People's Hospital of Xinzheng City, Xinzheng 451100, China
【Abstract】 Objective To observe the hypotensive effect of Sodium Nitroprusside and Nitroglycerin treatment of hypertensive emergencies, and evaluate the efficacy and safety. Methods 30 cases of hypertension were divided into two groups at random, a group was given continuous intravenous pumping Nitroglycerin, another group was given continuous pump into Sodium Nitroprusside. The treatment effect, heart rate and blood pressure medication and clinical manifestations of change were recorded, at the same time understanding reached initial goal of emergency treatment of hypertension. Results Sodium Nitroprusside and Nitroglycerin were significantly lower the blood pressure emergency patients in both groups, the hypotensive effect had no statistically significant (P>0.05). In the center of the process of antihypertensive, the change of heart rate had statistically different in two groups (P<0.05). Conclusion Nitroglycerin treatment of hypertensive emergencies is simple and the effect is satisfactory. Nitroglycerin is the first choice to treat hypertensive emergencies.
【Key words】 Hypertensive emergencies; Sodium Nitroprusside;Nitroglycerin; Treatment
高血压急症是内科常见病，指血压在短期内显著升高并伴靶器官损害，如高血压脑病，颅内出血，蛛网膜下腔出血，脑梗死，心肌梗死，不稳定心绞痛，急性左心衰肺水肿，急性主动脉夹层等伴严重高血压(收缩压≥220 mm Hg,舒张压>120 mm Hg),需紧急处理，否则将危及患者的生命。传统的紧急降压药首选硝普钠，但是硝普钠毒副作用较大，使其临床应用收到一定的限制。近年来，推荐静脉滴注硝酸甘油，替代硝普钠用于各种高血压危象[1]。2008年3月至2010年3月，采用静脉滴注硝酸甘油治疗高血压急症，疗效满意。本文观察了静脉滴注硝酸甘油治疗高血压急症的效果并与硝普钠进行对照，现在报告如下。
1 资料与方法
1.1 临床资料 30例高血压急症患者全部在我科就诊，均符合JVC-7(美国高血压指南)制定的高血压急症诊断标准，分别按就诊顺序随机分入硝酸甘油组(治疗组)15例和硝普纳组(对照组)15例。其中治疗组男9例，女6例，年龄44~87岁，平均60.4岁；对照组男7例，女8例，年龄43~88岁，平均59.8岁，两组病例在用药前病情、性别﹑年龄方面差异无统计学意义(P>0.05)。
1.2 降压治疗方法 对所有患者根据病情酌情给予吸氧、强心、利尿、脱水等治疗 ......
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