目的 探讨术前不同抗高血压治疗方案对高血压患者在麻醉诱导期间发生低血压的影响.方法 选择高血压手术患者95例,随机分为硝苯地平组(31例)、缬沙坦组(32例)和美托洛尔组(32例),术前分别服用相应的降压药物.所有患者均采用静脉吸入复合全身麻醉.记录3组患者诱导前(T0)、诱导后(T1)、插管后(T2)、插管后3 min(T3)的SBP、DBP、心率及麻醉诱导期低血压发生情况.结果 3组患者的SBP、DBP、心率随时间变化的趋势均无统计学差异(P＞0.05);T1时点缬沙坦组患者的SBP、DBP、心率水平和低血压事件发生比例均高于硝苯地平和美托洛尔组(均P＜0.05).结论 与缬沙坦比较,术前应用硝苯地平和美托洛尔的高血压患者麻醉诱导期血压控制均更平稳,发生低血压事件患者比例更低.%Objective To explore the effects of preoperative different antihypertensive treatment regimens on hypertensive patients with hypotension during anesthesia induction.Methods A total of 95 surgical patients with hypertension were randomly divided into nifedipine group(31 cases),valsartan group(32 cases) and metoprolol group(32 cases),and received corresponding antihypertensive drugs before operation.All patients were given combined general anesthesia with intravenous inhalation.SBP,DBP,heart rate before induction(T0), after induction(T1),after intubation(T2) and after three minutes of intubation(T3),and the incidence of hypotension during induction of anesthesia were compared among the three group.Results SBP,DBP and heart rate of the three groups presented a time-dependent trend and showed no statistically significant difference(P＞0.05).At T1,the levels of SBP,DBP and heart rate as well as the proportion of hypotension events in the valsartan group were higher than those in the nifedipine group or the metoprolol group(all P＜0.05).Conclusion In the induction of anesthesia,compared to patients using valsartan,a stabler blood pressure control and a lower proportion of hypotension events are observed in the patients using nifedipine or metoprolol before operation,and the hypotension events occur in a low proportion.
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