硝酸甘油注射液复合盐酸艾司洛尔注射液用于妊高征心衰的控制

目的寻找更有效控制妊高征产妇心衰的药物，为妊高征产妇心衰麻醉手术处理提供新方法。方法随机抽取广州市重症孕产妇救治中心妊高征心衰紧急剖宫产的产妇100例，采用双盲法随机分为A、B两组，每组50例。两组均进入手术室后先控制心衰后麻醉；A组硝酸甘油注射液5mg／ml以0．9％的氯化钠注射液稀释成10ml以0．05mg／kg快速单次静脉注射，同时复合盐酸艾司洛尔注射液1mg／kg快速单次静脉注射；B组单纯硝酸甘油注射液5mg／ml以0．9％的氯化钠注射液稀释10ml以0．05mg／kg快速单次静脉注射；4分钟、8分钟后观察各指标及相关症状并评判其有效性。结果A组产妇比B组控制心衰效果明显更好，用药后4分钟及8分钟A组SBP／DBP、HR、SPO2、RR、CVP、ECG等指标较B组明显改善俨〈0．05），端坐呼吸者可平卧接受气管插管麻醉。结论硝酸甘油注射液复合盐酸艾司洛尔注射液用于妊高征心衰比使用单纯硝酸甘油注射液更好，值得推广应用，硝酸甘油注射液与盐酸艾司洛尔注射液复合使用确能药效互补完全控制好心衰。

Control of heart failure in pregnancy-induced hypertension syndrome patients by nitroglycerin injection combined with Esmolol hydrochloride injection

Objective To find an effective medicine for the control of heart failure in pregnancy- induced hypertension syndrome patients, thus to supply a new way for the intra-operative anesthesia of the patients. Methods 100 caesarean delivered pregnancy-induced hypertension syndrome patients with heart failure, randomly sampled from the patients of Guangzhou Remedy Center for Severe Parturient Women, were equally allocated to group A and group B by double blind method, 50 cases in each group. Both groups received medicines for the control of heart failure before anesthesia. Group A was given rapid one-dose intravenous injection of 10 ml mixture of nitroglycerin injection 5 mg/mt diluted with 0.9% sodium chloride injection at 0.05 mg/kg, and was also given rapid one-dose intravenous injection of Esmolol hydrochloride injection at 1 mg/kg. Group B was only given rapid one-dose intravenous injection of 10 ml mixture of nitroglycerin injection 5 mg/ ml diluted with 0.9% sodium chloride injection at 0.05 mg/kg. Four and eight minutes later, the effectiveness was evaluated by the changes of heart failure parameters. Results Group A showed a better effect on the control of heart failure than group B. Four and eight minutes after the medication, SBP/DBP, HR, SPO2, RR, CVP and ECG were much improved in group A as compared with those in group B, the difference being significant （P〈0.05）. SPO2 was increased from 88 % to 93% in group A, and from 88% to 90% in group B. HR was reduced at average 20 beats per minute in group A while increased at average 16 beats per minute. After medication, the orthopnea patients in group A could received tracheal intubation anesthesia by lying on back. Conclusion Nitroglycerin injection combined with Esmolol hydrochloride injection exert a synergistic action on the control of heart failure in pregnancy-induced hypertension syndrome patients, showing good prospects for clinical application.