硫酸镁预处理对围术期高血压脑出血患者术中血压的影响

目的观察硫酸镁预处理对围术期高血压脑出血患者术中血压的影响。方法将高血压脑出血行急诊开颅手术患者40例随机分为镁剂组和对照组各20例。切皮前取静脉血测血镁水平。镁剂组锯颅骨前予硫酸镁40mg/kg静脉注入并配合静脉泵注尼卡地平降压治疗;对照组仅予静脉泵注尼卡地平降压治疗。观察并记录2组麻醉前、麻醉诱导、气管插管、切皮、锯颅骨、打开脑膜和缝皮时的平均动脉压水平(MAP)、血压波动值(△P)和尼卡地平用量。结果锯颅骨前各观察时点2组MAP、△P和尼卡地平用量比较差异均无统计学意义(P>0.05);锯颅骨后各观察时点镁剂组MAP与△P均低于对照组,尼卡地平用量少于对照组,差异均有统计学意义(P<0.05)。结论不稳定高血压脑出血患者行开颅术锯颅骨前予硫酸镁预处理,可使患者血压平稳,并减少降压药用量,值得临床推广应用。

Influence of magnesium sulfate pretreatment on intraoperative blood pressure of patient with hypertension cerebral hemorrhage during perioperative

Objective To observe the influence of magnesium sulfate pretreatment on intraoperative blood pressure of pa- tient with hypertension cerebral hemorrhage during perioperative. Methods 40 cases patients with hypertension cerebral hem- orrhage and underwent emergency craniotomy were randomly divided into magnesium group and control group, each of 20 ca- ses. Before skin incision, took venous blood and test the magnesium level. Oberserved and noted the mean arterial pressure （MAP） ,blood pressure fluctuation value （△P） and nicardipine dosage. Results Before opening skull, the MAP,△ P and nicardipine dosage had no differences between 2 groups （ P 〉 0.05 ） ; After opening skull, the MAP and △ P of magnesium group was lower than that of control group, and the nicardipine dosage of magnesium group was less than that of control group, the difference was statistically significant （ P 〈 0. 05 ）. Conclusion Giving magnesium sulfate pretreatment to patients with hyper- tension cerebral hemorrhage before opening skull, can make blood pressure smoothly and reduce the drug dosage.