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高血压患者全麻诱导后顽固性低血压一例

徐艳,刘馨,姜春玲

Journal of Clinical Anesthesiology（2020）

Cited 1|Views6
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Abstract
患者,男,63岁,173 cm,90 kg,ASA Ⅲ级,因"腰部疼痛8个月"入院. 既往有高血压病史10年,规律服用厄贝沙坦片0. 15 g(每天1次) ,BP 135～160/60～95 mmHg. 8个月前因"腰椎间盘突出伴椎管狭窄症"于我院行全麻下"L4椎板切除、椎管减压术",术中行神经根松解时曾突发BP 降低、HR减慢,BP最低降低至50/30 mmHg,HR减慢至38次/分, ECG提示ST段抬高、Ⅱ度房室传导阻滞,数秒后发生室颤,立即仰卧位行胸外心脏按压,间断肾上腺素0. 5～1. 0 mg静注,总量3 mg,碳酸氢钠250 ml静滴等对症处理,2 min后心跳恢复自主心律,生命体征平稳.
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