静脉滴注硝酸甘油控制性降压在高血压高危人群胃镜检查中的应用

张莹; 何向阳

doi:10.13898/j.cnki.issn.1000-2200.2019.04.010

静脉滴注硝酸甘油控制性降压在高血压高危人群胃镜检查中的应用

张莹,
何向阳

Application value of intravenous nitroglycerin controlled hypotension in the gastroscopy of high risk population with hypertension

摘要

摘要:
目的探讨硝酸甘油静脉滴注控制性降压在高血压高危人群胃镜检查中的应用，并比较其与口服硝苯地平及硝酸甘油片降压的效果。
方法选取行电子胃镜检查的高血压高危人群120例，随机分为3组，各40例。行胃镜检查前15 min，3组分别给予硝苯地平片口服（A组）、硝酸甘油片口服（B组）和硝酸甘油静脉滴注（C组）降压。另抽取40名血压正常的受检者作为对照组。比较4组受检者在检查前、检查中、检查后的血压、心率和心电图改变情况，记录4组不良反应发生情况。
结果检查前，A、B组病人收缩压和心率均高于对照组（P < 0.05~P < 0.01）；检查中，A、B组收缩压、舒张压和A组心率均高于C组和对照组（P < 0.05~P < 0.01）；检查后，A组收缩压和心率均高于C组和对照组（P < 0.05~P < 0.01）。C组病人除检查前收缩压和检查后心率高于对照组（P < 0.01和P < 0.05）外，各检查阶段的其他指标与对照组差异均无统计学意义（P>0.05）。检查前和检查后，3组病人窦性心动过速、ST改变、异位心律（包括房早、室早、室上性心动过速）、传导阻滞4种异常心电图发生率差异均无统计学意义（P>0.05）；检查过程中，3组ST改变和异位心律差异均有统计学意义（P < 0.05）。4组受检者不良反应差异无统计学意义（P>0.05）。
结论硝酸甘油静脉滴注在高血压高危人群行胃镜检查过程中能平稳控压，较口服硝苯地平片及硝酸甘油片效果更佳，有助于保障高血压病人安全。

Abstract:
ObjectiveTo investigate the application value of intravenous nitroglycerin controlled hypotension in the gastroscopy of high risk population with hypertension, and compare the effects between nitroglycerin and nifedipine by oral in controlling blood pressure.
MethodsOne hundred and twenty hypertensive patients treated with electronic gastroscopy were randomly divided into the group A(treatment with nifedipine by oral), group B(treatment with nitroglycerin by oral), and group C(treatment with intravenous nitroglycerin).Forty healthy people were set as control group.The blood pressure, heart rate, ECG and incidence rate of adverse reactions in four groups were observed through the whole process of gastroscopy inspection.
ResultsBefore inspection, the levels of systolic blood pressure and heart rate in group A and group B were higher than those in control group(P < 0.05 to P < 0.01).During the inspection, the levels of systolic and diastole pressure in group A and group B, and heart rate in group A were higher than those in group C and control group(P < 0.05 to P < 0.01).After inspection, the level of systolic pressure and heart rate in group A were higher than those in group C and control group(P < 0.05 to P < 0.01).The level of systolic pressure before inspection and heart rate after inspection in group C were higher than those in control group(P < 0.01 and P < 0.05), and the differences of other indexes between group C and control group were not statistically significant(P>0.05).Before and after inspection, the differences of the incidence rates of sinus tachycardia, ST change, ectopic heart rhythm and conduction block among three groups were not statistically significant(P>0.05).During the inspection, the differences of ST change and ectopic heart rhythm among three groups were statistically significant(P < 0.05).The differences of the incidence rates of adverse reactions among four groups were not statistically significant(P>0.05).
ConclusionsIntravenous nitroglycerin is a safe method in controlling the blood pressure during gastroscopy, the effect of which is better than that of nifedipine and nitroglycerin by oral.

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