摘要
目的分析去甲肾上腺素的应用剂量对感染性休克患者血流动力学及预后的影响。方法选取2010年2月~2016年12月我院感染性休克患者42例,随机分为治疗组和常规组。常规组患者在病因治疗、容量治疗的基础上静脉滴注去甲肾上腺素0.1μg/(kg·min),治疗组患者在常规治疗的基础上静脉滴注去甲肾上腺素0.3μg/(kg·min),之后每5分钟增加一次剂量,直至达到最高剂量1.0μg/(kg·min)。分别比较治疗前,治疗后6、12、24h患者的平均动脉压(MAP)、心率(HR)、心脏指数(CI)、全身血管阻力指数(SVRI)、中心静脉压(CVP)等血流动力学指标,统计治疗期间的不良反应和并发症的发生情况进行预后比较。结果治疗组与常规组的MAP、HR、SVRI、CI和CVP等血流动力学参数比较差异无统计学意义,与治疗前比较,两组治疗后6、24h的MAP升高、HR及CVP降低,差异有统计学意义。治疗组不良反应和并发症的总发生率比常规剂量组高,差异有统计学意义(P<0.05)。结论在感染性休克患者的治疗,大剂量的去甲肾上腺素并不会增加疗效,且会增加毒副反应,加重循环的障碍,影响患者的预后。
Objective To explore the effect of norepinephrine dose on hemodynamics and prognosis in patients with septic shock. Methods 42 cases of septic shock in our hospital from February 2010 to December 2016 were selected and randomly divided into treatment group and routine group. Patients in routine group were treated with intravenous infusion of norepinephrine 0. 1 μL g/（kg · min） on the basis of etiological treatment and volume therapy, and patients in treatment group were teated with intravenous infusion of norepinephrine 0.3 μL g/（kg ·min） on the basis of conventional treatment, and then, the dose was increased every 5min until the highest dose was 1g/（kg · min）. The hemodynamic indexes such as mean arterial pressure（MAP）, heart rate（HR）, heart inde （CI）, systemic vascular resistance index （SVRI）, central venous pressure（CVP） and so on were compared before and after treatment in 6, 12 and 24h patients, respectively. The prognosis of the adverse events and complications was compared during a statistical treatment. Results The hemodynamie parameters such as MAP, HR, SVRI, CI and CVP in the treatment group and the conventional group were not significantly different. Compared with before treatment, the 6 groups of MAP, 24h, HR and CVP decreased after treatment, and the difference was statistically significant between two groups. The total incidence of adverse reactions and complications in the treatment group was higher than that in the routine dose group, and the difference was statistically significant（P 〈 0.05）. Conclusion In the treatment of septic shock, large doses of norepinephrine do not increase efficacy. And it can increase the side effects, aggravate the circulatory disorder, and affect the prognosis of the patients.
作者
颜春悦
叶晓东
蒋龙元
YAN Chunyue YE Xiaodong JIANG Longyuan(Department of Emergency, Shanwei Second People＇s Hospital, Shanwei Yihui＇s Funds Hospitals, Shanwei 516600, China Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou 510000, China)
出处
《中国医药科学》
2017年第9期72-74,共3页
China Medicine And Pharmacy
