摘要
目的探讨去甲肾上腺素(NE)治疗重症感染性休克患者的效果及对血流动力学和肾功能指标的影响。方法选取山东省单县东大医院2021年1月-2023年1月收治的128例重症感染性休克患者,以便利抽样法将患者随机分成两组,每组64例。予以多巴胺(DA)治疗的患者为对照组,使用NE治疗的患者为观察组。比较两组患者的治疗疗效、血流动力学、肾功能指标、炎性因子及不良反应。结果观察组治疗总有效率高于对照组,对比差异显著(P<0.05)。治疗前两组心率、平均动脉压对比差异不显著(P>0.05);治疗后观察组心率低于对照组,平均动脉压高于对照组(P<0.05)。治疗前两组患者尿素氮、血肌酐对比差异不显著(P>0.05);治疗后观察组尿素氮、血肌酐指标低于对照组(P<0.05)。治疗前两组患者C反应蛋白(CRP)、白介素-6(IL-6)对比差异不显著(P>0.05);治疗后两组均显著下降且两组CRP、IL-6对比差异不显著(P>0.05)。观察组不良反应发生率低于对照组,但对比差异不显著(P>0.05)。结论使用NE治疗重症感染性休克患者可取得理想的治疗效果,维持患者血流动力学指标的稳定,相较DA,虽然会降低肾血流量但可维持灌注压,因而能减少肾损伤的发生。NE在促进机体炎性反应改善中的作用效果与DA基本相当,且不会增加不良反应发生风险,因而更建议使用NE进行重症感染性休克患者的治疗。
Objective To investigate the effect of norepinephrine(NE)on hemodynamics and renal function in patients with severe septic shock.Methods 128 patients with severe infectious shock admitted to our hospital from January 2021 to January 2023 were randomly divided into two groups with convenient sampling method,64 patients in each group.Patients treated with dopamine(DA)were in the control group,while patients treated with NE were in the observation group.The therapeutic efficacy,hemodynamics,renal function indicators,inflammatory factors,and adverse reactions of the two groups of patients were compared.Results The total effective rate of treatment in the observation group was higher than that in the control group,with a significant difference(P<0.05).There was no significant difference in heart rate and mean arterial pressure between the two groups before treatment(P>0.05);after treatment,the heart rate of the observation group was lower than control group,and mean arterial pressure was higher than control group(P<0.05).Before treatment,there was no significant difference in urea nitrogen and serum creatinine between the two groups(P>0.05);after treatment,the indexes of urea nitrogen and serum creatinine in the observation group were lower than those in the control group(P<0.05).Before treatment,there was no significant difference in C-reactive protein(CRP)and interleukin-6(IL-6)between the two groups(P>0.05);after treatment,both groups showed a decrease and there was no significant difference in CRP and IL-6 between the two groups(P>0.05).The incidence of adverse reactions in the observation group was lower than that in the control group,but the difference in comparison was not significant(P>0.05).Conclusion The use of NE in the treatment of patients with severe septic shock can achieve an ideal therapeutic effect,maintain the stability of hemodynamic parameters,and reduce the incidence of renal injury compared to DA,although it can reduce renal blood flow but maintain perfusion pressure.The effect of NE in promotin
作者
李洋
姬博
Li Yang;Ji Bo(Shan County Dongda Hospital,Heze,Shandong 274300,China)
出处
《首都食品与医药》
2023年第13期56-58,共3页
Capital Food Medicine
