乌拉地尔与硝普钠对高血压脑出血降压效果的对比论文_高洪梅

黑龙江省伊春市西林区人民医院 153025

摘要:目的:对比乌拉地尔与硝普钠对高血压脑出血降压的效果。方法:随机的选择2017年6月到2018年6月来我院就诊的高血压脑出血患者60例,按照随机分配的原则将这60名患者分成两组,每组30例。分别将这两个组命名为实验组和对照组。对照组患者用硝普钠进行疾病的治疗,实验组患者使用乌拉地尔注射液进行治疗。在开始治疗的一段时间内定时比较两组患者血肿量神经功能评分、疾病相关参数与不良反应发生率等指标,从而比较两种药物在高血压脑出血的治疗当中的降压效果。结果:两组患者在分别用药后的几段时间内进行相关指标的检测,实验组患者平均收缩压及平均舒张压高于对照组患者,实验组患者的平均心率低于对照组患者的平均心率,组间差异具有统计学意义(P<0.05)。除此之外,实验组患者的不良反应发生率明显要低于对照组。结论:乌拉地尔对高血压脑出血降压的效果比硝普钠更有效,而且患者的恢复效果更好,值得在临床上推广使用。

关键词:乌拉地尔;硝普钠;高血压脑出血降压

Comparative study of antihypertensive effect of urapidil and sodium nitroprusside on hypertensive cerebral hemorrhage

Abstract: Objective: To compare the effects of urapidil and sodium nitroprusside on blood pressure reduction in hypertensive cerebral hemorrhage. METHODS: Sixty patients with hypertensive intracerebral hemorrhage who came to our hospital from June 2017 to June 2018 were randomly selected. The 60 patients were divided into two groups according to the principle of randomization, 30 in each group. The two groups were named as the experimental group and the control group, respectively. Patients in the control group were treated with sodium nitroprusside, and patients in the experimental group were treated with urapidil. In the period of starting treatment, the neurological function scores, disease-related parameters and incidence of adverse reactions were compared regularly between the two groups to compare the antihypertensive effects of the two drugs in the treatment of hypertensive intracerebral hemorrhage. RESULTS: The two groups of patients were tested for relevant indicators within a few periods after the drug administration. The average systolic blood pressure and mean diastolic blood pressure of the experimental group were higher than those of the control group. The average heart rate of the experimental group was lower than that of the control group. The difference between the groups was statistically significant (P<0.05). In addition, the incidence of adverse reactions in the experimental group was significantly lower than that in the control group. Conclusion: Urapidil is more effective than sodium nitroprusside in the treatment of hypertensive cerebral hemorrhage, and the recovery effect of patients is better. It is worthy of clinical use.

Key words: urapidil; sodium nitroprusside; hypertension cerebral hemorrhage

引言:高血压脑出血属于目前临床上常见急症,具有较高的病死率与致残率[1]。随着生活水平的提高,其发病率也在逐年提升[2],发病年龄也逐渐年轻化。多数高血压脑出血患者发病后就会表现出明显的血压升高,尤其是在发病后24h之内,血压的增高是显著的。颅内减压术是针对脑出血后常规的治疗方式之一,但治疗效果有限,无法达到人们预期的目标,因此临床上常以药物治疗加以辅助。现阶段常用药物为乌拉地尔与硝普钠,本文就这两种药物的降压疗效进行探讨。

资料与方法

1.1一般资料

随机的选择2017年6月到2018年6月来我院就诊的高血压脑出血患者60例,按照随机分配的原则将这60名患者分成两组,每组30例。分别将这两个组命名为实验组和对照组。实验组的30名患者当中有男性患者15例,女性患者15例。年龄分布为41-76岁之间,平均年龄在(54.2±3.18)岁。发病时间2~46h,平均发病时间(12.3±4.2)h,蛛网膜下腔出血14例,颅内出血16例。对照组当中有14例男性患者,16例女性患者。患者的年龄分布为45-77岁之间,平均年龄在(55.34±2.45)岁。发病时间6~44h,平均发病时间(13.11±4.78)h,蛛网膜下腔出血12例,颅内出血18例。两组在性别、年龄及病程、血压、出血部位、血肿体积、神经功能评分等方面具有可比性。

1.2方法

两组患者入院的时候均接受常规的治疗。随后对照组患者用硝普钠治疗,治疗初始剂量为0.5~1.0μg/(kg∙min),实验组患者用乌拉地尔注射液治疗。对照组的患者将硝普钠100mg用5%葡萄糖溶液或生理盐水50ml稀释后用微量泵输入,遮光。实验组患者将200mg乌拉地尔溶于50mL的0.9%生理盐水静脉微量注射泵输入,以最低速度输入,随后实时监测患者的血压以调整速度。治疗一段时间之后比较两组患者血肿量神经功能评分、疾病相关参数与不良反应发生率等指标,从而比较两种药物在高血压脑出血的治疗当中的降压效果。

2.结果

3.讨论

高血压性脑出血是常见的脑血管病,其病死率、致残率高,为我国死亡三大原因之一[3]。一般该病通过手术和药物配合治疗,主要采用不影响颅内压、温和的药物,临床上主要包括硝普钠、乌拉地尔。通过实验结果来看,实验组患者平均收缩压及平均舒张压高于使用对照组患者,实验组患者的平均心率低于对照组患者的平均心率,而且不良反应较少,所以值得在临床上推广使用。

参考文献:

[1]张建军,高国梁,董伟峰,等.尼莫地平在高血压脑出血术后的降压疗效〔J〕.中国新药与临床杂志,2005,24(05):379-382.

[2]杨志雄,余冬平,杨仕光.尼卡地平和乌拉地尔对高血压脑出血术后的疗效比较[J].中国实用神经疾病杂志,2010,13(05):1236~1238.

[3]段慧,韩国辉,王秋娟.硝普钠联合乌拉地尔治疗脑出血急性期高血压的对照研究[J].中国实用神经疾病杂志,2014,17(12):129~221.

论文作者:高洪梅

论文发表刊物:《中国医学人文》2018年22期

论文发表时间:2019/5/28

标签:;  ;  ;  ;  ;  ;  ;  ;  

乌拉地尔与硝普钠对高血压脑出血降压效果的对比论文_高洪梅
下载Doc文档

猜你喜欢