多巴胺与间羟胺联合使用对颈动脉支架置入术后持续性低血压患者的影响
摘要
目的探讨多巴胺与间羟胺联合使用对颈动脉支架置入术后持续性低血压患者心律失常及其他并发症的影响。方法选取行颈动脉支架置入术后持续性低血压的患者500例为研究对象。253例给予0. 9%生理盐水35 ml+多巴胺150 mg微泵泵入为单用组。247例给予0. 9%生理盐水42 ml+多巴胺60 mg+间羟胺38 mg微泵泵入为双用组。比较两组患者不同时间升压药物使用剂量,对心率和血压的影响及心律失常和其他并发症的发生率。结果第3天及以后,双用组使用升压药物的例数明显少于单用组,多巴胺使用剂量明显少于单用组,差异均有统计学意义(P <0. 01)。第5天及以后,双用组对心率的影响明显小于单用组,差异有统计学意义(P <0. 01)。双用组并发症(心动过速、心律失常、心绞痛、TIA及脑梗死)发生率明显小于单用组,差异有统计学意义(P <0. 05)。结论多巴胺与间羟胺联合使用能明显减少颈动脉支架置入术后持续性低血压患者心律失常及其他并发症的发生,缩短升压药物使用时间,减少工作量,值得在临床推广应用。
引文
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[16]陈茂华,陆川,孙军.椎基底动脉狭窄支架置入前后血流动力学变化的初步研究[J].中国医师杂志,2012,14(7):871-873. DOI:10. 3760/cma. j. issn. 1008-1372. 2012. 07. 003.
[2]马志芬.颈动脉支架植入病人发生持续性低血压的危险因素分析及护理[J].护理研究,2016,30(2):164-166. DOI:10.3969/j. issn. 1009-6493. 2016. 02. 012.
[3]陈新谦,金有豫,汤光.新编药物学[M].北京:人民卫生出版社,2011:412-416.
[4]Chimowitz MI,Lynn MJ,Derdeyn CP,et al. Stenting versus aggressive medical therapy for intracranial arterial stenosis[J]. N Engl J Med,2011,365(11):993-1003. DOI:10. 1056/NEJMoa1105335.
[5]符晓艳.脑血管支架置入术后持续性低血压患者焦虑和抑郁状态的影响及心理干预[J].现代医药卫生,2015,31增刊:39-41. DOI:10. 3969/j. issn. 1009-5519. 2015. 26. 018.
[6]万学红,卢雪峰.诊断学[M]. 9版.北京:人民卫生出版社,2018:501-508.
[7]贾建平,陈生弟.神经病学[M]. 7版.北京:人民卫生出版社,2013:172-188.
[8]Cheng L,Jiao L,Gao P,et al. Risk factors associated with inhospital serious adverse events after stenting of severe symptomatic intracranial stenosis[J]. Clin Neurol Neurosurg,2016,147:59-63. DOI:10. 1016/j. clineuro. 2016. 05. 019.
[9]许丽华,陈虹,马婷,等.颈动脉支架置入血管成形术后低血压相关因素分析[J].中国老年学杂志,2010,30(15):2112-2115. DOI:10. 3969/j. issn. 1005-9202. 2010. 15. 013.
[10]隗立兵,王春梅,黄莹,等.颈动脉支架成形术后持续性低血压危险因素分析[J].介入放射学杂志,2016,25(8):651-653.DOI:10. 3969/j. issn. 1008-794X. 2016. 08. 001.
[11]Wang L,Tao Y,Chen Y,et al. Association of post stroke depression with social factors,insomnia,and neurological status in Chinese elderly population[J]. Neurol Sci,2016,37(8):1305-1310. DOI:10. 1007/s10072-016-2590-1.
[12]Rubio G,Karwowski JK,De Amorim H,et al. Predicting Factors Associated with Postoperative Hypotension following Carotid Artery Stenting[J]. Ann Vasc Surg,2018,DOI:10.1016/j. avsg.2018.06.005.
[13]Ishii D,Sakamoto S,Okazaki T,et al. Overlapped Stenting Is Associated with Postoperative Hypotension after Carotid Artery Stenting[J]. J Stroke Cerebrovasc Dis,2018,27(3):653-659.DOI:10. 1016/j. jstrokecerebrovasdis. 2017. 09. 041.
[14]Dumont TM,Wach MM,Mokin M,et al. Perioperative complications after carotid artery stenting:a contemporary experience from the university at buffalo neuroendovascular surgery team[J]. Neurosurgery,2013,73(4):689-693; discussion 693-694. DOI:10.1227/NEU. 0000000000000077.
[15]G?k?al E,Niftaliyev E,Deniz,et al. Prolonged hypotension after carotid artery stenting:incidence,predictors and consequences[J]. Acta Neurochir(Wien),2017,159(11):2081-2087. DOI:10. 1007/s00701-017-3295-9.
[16]陈茂华,陆川,孙军.椎基底动脉狭窄支架置入前后血流动力学变化的初步研究[J].中国医师杂志,2012,14(7):871-873. DOI:10. 3760/cma. j. issn. 1008-1372. 2012. 07. 003.