目的探讨血管活性药物评分(VIS)与脓毒性休克患儿预后的关系。方法以接受血管活性药物治疗的117例失代偿型脓毒性休克患儿为研究对象,根据预后分为死亡组(41例)和存活组(76例),根据第1个24 h最大VIS(24 h VIS max)的临界点分为低VIS组(7...目的探讨血管活性药物评分(VIS)与脓毒性休克患儿预后的关系。方法以接受血管活性药物治疗的117例失代偿型脓毒性休克患儿为研究对象,根据预后分为死亡组(41例)和存活组(76例),根据第1个24 h最大VIS(24 h VIS max)的临界点分为低VIS组(78例)和高VIS组(39例)。计算所有患儿24 h VIS max和第1个24 h VIS 平均值(24 h VISmean),并对VIS与脓毒性休克预后的关系进行受试者工作特征曲线(ROC)分析。结果死亡组 24 h VIS max、24 h VISmean、PRISMⅢ评分、血管活性药物使用前及24 h后的乳酸均明显高于存活组(P<0.05)。24 h VIS max、24 h VISmean、PRISMⅢ评分、血管活性药物使用前和24 h后的乳酸以及24 h 后的pH对于脓毒性休克预后均具有一定的预测价值,但以24 h VIS max的曲线下面积(AUC)最大(P<0.05)。高VIS组的死亡人数、PRISM Ⅲ评分、治疗前及治疗24 h后的乳酸均明显高于低VIS组(P<0.05)。结论血管活性药物评分与脓毒性休克患儿的病死率有关,血管活性药物评分越高,病情越危重,病死率越高。展开更多
Effects of angiotensin Ⅱ and other six vasoactive agents on tissue blood flow of Yoahida rat ascites hepatoma AH109A and normal liver were measured by the hydrogen clearance method. The mean blood flow in the tumor p...Effects of angiotensin Ⅱ and other six vasoactive agents on tissue blood flow of Yoahida rat ascites hepatoma AH109A and normal liver were measured by the hydrogen clearance method. The mean blood flow in the tumor peripheral part under normal tension was 11. 9±8. 2ml/ min/100g tissue and was not influenced by tumor size. Tumor blood flow was more significantly increased in infusion angiotensin Ⅱthan 0.5mg/ ml methoxamine, however, normal liver blood flow of tumor-bearing rats was unchanged in contrast to an Increase seen in the tumor. A pronounced reduction of tumor blood flow was found after administration of epinephrine, norepinephrin and ethylphenylephrine. In addition, metaraminol and phenyleprine as well as 1. 0 and 2. 5mg/ ml methoxamine were not found to significantly change blood flow of the tumor.展开更多
目的探讨总结严重多发伤救治中,多巴胺、酚妥拉明等血管活性药的治疗疗效及临床意义。方法对ISS≥17分的严重多发伤,有心肺功能不全或ARDS、ALI,或CVP>8 cmH2O、SBP(收缩压)>90 mm Hg,有微循环灌注不良,年龄大,原有慢性心肺病患...目的探讨总结严重多发伤救治中,多巴胺、酚妥拉明等血管活性药的治疗疗效及临床意义。方法对ISS≥17分的严重多发伤,有心肺功能不全或ARDS、ALI,或CVP>8 cmH2O、SBP(收缩压)>90 mm Hg,有微循环灌注不良,年龄大,原有慢性心肺病患并发肺部感染者,予以小剂量多巴胺、多巴酚丁胺及酚妥拉明微量泵持续泵入,同时监测CVP、呼吸、心率及动脉血气等。结果多发伤后早期急性心肺功能不全的检出率分别达42.3%及51.9%;血管活性药可改善胸闷、气短等临床症状,减慢过快呼吸、心跳,提高PaO2及SaO2,有效率达93.0%。结论严重创伤导致过度应激反应,以外周血管收缩为伤后儿茶酚胺释放的主要特征,小剂量多巴胺及酚妥拉明类血管活性药,可增强创伤后不同基础患者心肺功能,改善预后。展开更多
文摘目的探讨血管活性药物评分(VIS)与脓毒性休克患儿预后的关系。方法以接受血管活性药物治疗的117例失代偿型脓毒性休克患儿为研究对象,根据预后分为死亡组(41例)和存活组(76例),根据第1个24 h最大VIS(24 h VIS max)的临界点分为低VIS组(78例)和高VIS组(39例)。计算所有患儿24 h VIS max和第1个24 h VIS 平均值(24 h VISmean),并对VIS与脓毒性休克预后的关系进行受试者工作特征曲线(ROC)分析。结果死亡组 24 h VIS max、24 h VISmean、PRISMⅢ评分、血管活性药物使用前及24 h后的乳酸均明显高于存活组(P<0.05)。24 h VIS max、24 h VISmean、PRISMⅢ评分、血管活性药物使用前和24 h后的乳酸以及24 h 后的pH对于脓毒性休克预后均具有一定的预测价值,但以24 h VIS max的曲线下面积(AUC)最大(P<0.05)。高VIS组的死亡人数、PRISM Ⅲ评分、治疗前及治疗24 h后的乳酸均明显高于低VIS组(P<0.05)。结论血管活性药物评分与脓毒性休克患儿的病死率有关,血管活性药物评分越高,病情越危重,病死率越高。
文摘Effects of angiotensin Ⅱ and other six vasoactive agents on tissue blood flow of Yoahida rat ascites hepatoma AH109A and normal liver were measured by the hydrogen clearance method. The mean blood flow in the tumor peripheral part under normal tension was 11. 9±8. 2ml/ min/100g tissue and was not influenced by tumor size. Tumor blood flow was more significantly increased in infusion angiotensin Ⅱthan 0.5mg/ ml methoxamine, however, normal liver blood flow of tumor-bearing rats was unchanged in contrast to an Increase seen in the tumor. A pronounced reduction of tumor blood flow was found after administration of epinephrine, norepinephrin and ethylphenylephrine. In addition, metaraminol and phenyleprine as well as 1. 0 and 2. 5mg/ ml methoxamine were not found to significantly change blood flow of the tumor.
文摘目的探讨总结严重多发伤救治中,多巴胺、酚妥拉明等血管活性药的治疗疗效及临床意义。方法对ISS≥17分的严重多发伤,有心肺功能不全或ARDS、ALI,或CVP>8 cmH2O、SBP(收缩压)>90 mm Hg,有微循环灌注不良,年龄大,原有慢性心肺病患并发肺部感染者,予以小剂量多巴胺、多巴酚丁胺及酚妥拉明微量泵持续泵入,同时监测CVP、呼吸、心率及动脉血气等。结果多发伤后早期急性心肺功能不全的检出率分别达42.3%及51.9%;血管活性药可改善胸闷、气短等临床症状,减慢过快呼吸、心跳,提高PaO2及SaO2,有效率达93.0%。结论严重创伤导致过度应激反应,以外周血管收缩为伤后儿茶酚胺释放的主要特征,小剂量多巴胺及酚妥拉明类血管活性药,可增强创伤后不同基础患者心肺功能,改善预后。
