Leeman M, Degaute J P
Clinique d'hypertension artérielle, hôpital universitaire Erasme, Bruxelles, Belgique.
Arch Mal Coeur Vaiss. 1993 Aug;86(8):1267-8.
Treatment of high blood pressure after abdominal aortic surgery requires, because of adynamic ileus, the use of intravenously or sublingually (SL) administered drugs. The hemodynamic responses to captopril 25 mg SL (n = 10) and to nifedipine 10 mg SL (n = 10) were studied for 2 hours in patients (mean age 66 years) with arterial hypertension (mean blood pressure, Pa > or = 115 mmHg) the day after abdominal aortic surgery. Patients with bilateral renal artery stenoses, identified with the preoperative angiogram, were excluded. Systemic arterial pressure and pulmonary vascular pressures were measured using a femoral catheter and a pulmonary artery catheter respectively. Cardiac output (Q) was determined by thermodilution. [table: see text] Captopril and nifedipine significantly decreased pulmonary artery pressure, pulmonary artery occlusion pressure and right atrial pressure. No deterioration of renal function was observed. In conclusion, captopril and nifedipine SL are effective and well tolerated for the treatment of high blood pressure after abdominal aortic surgery.
由于存在动力性肠梗阻,腹主动脉手术后高血压的治疗需要使用静脉注射或舌下含服的药物。对10例平均年龄66岁、腹主动脉手术后第1天患有动脉高血压(平均血压,Pa≥115 mmHg)的患者,研究了舌下含服25 mg卡托普利(n = 10)和舌下含服10 mg硝苯地平(n = 10)2小时后的血流动力学反应。通过术前血管造影确定的双侧肾动脉狭窄患者被排除。分别使用股动脉导管和肺动脉导管测量体循环动脉压和肺血管压力。心输出量(Q)通过热稀释法测定。[表:见原文]卡托普利和硝苯地平显著降低了肺动脉压、肺动脉闭塞压和右心房压。未观察到肾功能恶化。总之,舌下含服卡托普利和硝苯地平对腹主动脉手术后高血压的治疗有效且耐受性良好。