摘要
目的：探讨目标导向液体治疗（GDT）对异位妊娠破裂并发失血性休克患者围手术期心肌酶谱的影响。方法：选择50例行异位妊娠破裂并发失血性休克择期手术患者,依据随机数字表法分为GDT组（A组）和常规液体治疗组（B组）,各25例。记录2组术前（T0）、手术开始（T1）、手术开始后30 min（T2）、手术开始后1 h（T3）、手术开始后2 h（T4）、手术结束（T5）的血流动力学指标和血清肌酸激酶及其同工酶以及肌钙蛋白T的变化,并对其进行分析。结果：A组T2、T5的血清肌酸激酶和T2~T5同工酶及肌钙蛋白T水平均低于B组（P〈0.05~P〈0.01）。A组T1~T3的心率均低于B组（P〈0.01）,而T1~T3时点的平均动脉压以及T2时点中心静脉压均高于B组（P〈0.05~P〈0.01）。结论：GDT应用于异位妊娠破裂并发失血性休克患者能增加围手术期有效容量负荷,且具有一定的心肌保护作用。
Objective： To evaluate the effects of goal-direct therapy（ GDT） on perioperative cardiac enzyme in ectopic pregnancy patients with hemorrhagic shock. Methods： Fifty ectopic pregnancy patients with hemorrhagic shock scheduled by operation were divided into the goal-direct therapy（ GDT） group（ group A,25 cases） and conventional infusion treatment group（ group B,25 cases） by random number table method. The hemodynamics change,serum creatine kinase,isoenzyme of creatine kinase and troponin T in two groups were recorded before operation（ T0）,at the start of operation（ T1）,after 30 min（ T2）,1h（ T3）,2h（ T4） and at the end of operation（ T5）,and the data were analyzed. Results： The levels of serum creatine kinase,isoenzyme of creatine kinase and troponin T in group A were lower than those in group B from T2 to T5（ P〈0. 05 to P〈0. 01）. The levels of HR and MAP from T1 to T3and CVP at T2 in group A were higher than those in group B（ P〈0. 01）. Conclusions： The treatment of ectopic pregnancy patients with hemorrhagic shock with GDT can increase the effective capacity load of myocardium,and has a certain myocardial protection.
出处
《蚌埠医学院学报》
CAS
2016年第4期475-478,共4页
Journal of Bengbu Medical College
