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目的 :观察压宁定抑制支撑喉镜下声带手术中血压升高的临床效果。方法 :选择ASAⅠ～Ⅱ级无高血压病史 ,择期行支撑喉镜下声带手术的患者共 40例 ,随机分为实验组 (Ⅰ组 )与对照组 (Ⅱ组 )各 2 0例。麻醉诱导后采用内径 (ID)为 5mm带套囊气管导管鼻腔插管 ,喷射呼吸机常频通气 ,实验组在放置支撑喉镜前 5min静注压宁定每公斤体重 4mg,记录术前、用药后 0 ,5 ,10 ,15minSBP ,DBP ,HR变化及用药后 0～15min高血压 (SBP≥ 2 1 3kPa)发生例数。结果 :用药后 5minSBP ,DBP(P <0 0 1)及 15minSBP(P <0 0 5 )两组差异有显著意义 ,实验组高血压 (SBP≥ 2 1 3kPa)发生率明显低于对照组 (P <0 0 1)。结论 :单次静注压宁定每公斤体重 4mg可有效抑制支撑喉镜下声带手术中的心血管应激反应。
OBJECTIVE: To observe the clinical effect of nifedipine in inhibiting the rise of blood pressure during vocal cord surgery with support laryngoscope. Methods: A total of 40 ASA grade Ⅰ ~ Ⅱ patients with no history of hypertension were enrolled in this study. They were randomly divided into experimental group (group Ⅰ) and control group (group Ⅱ). After induction of anesthesia, an ID (id) of 5 mm with nasal cuffed endotracheal intubation was used. Ventilator was ventilated regularly. In the experimental group, 5 mg of body weight was given intravenously 5 minutes before the support laryngoscope was placed. After 0, 5, 10, 15minSBP, DBP, HR changes and 0-15min after treatment of hypertension (SBP ≥ 21 3kPa) occurred in the number of cases. Results: The differences of SBP, DBP (P <0.01) and 15minSBP (P <0.05) between the two groups were significant at 5 minutes after treatment. The incidence of hypertension (SBP> 21.3 kPa) in experimental group was significantly lower than that in control group <0 0 1). Conclusion: The single intravenous injection of nifedipine 4mg per kilogram of body weight can effectively suppress the cardiovascular stress during vocal cord surgery under support laryngoscopy.