去甲肾上腺素联合多巴酚丁胺治疗心源性休克的临床效果
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摘要
目的探讨去甲肾上腺素联合多巴酚丁胺治疗心源性休克的临床效果。方法选取2016年8月～2018年8月我院收治的68例心源性休克患者作为研究对象,按照随机分组方法将其分为单一组(34例)与联合组(34例)。单一组患者采用多巴酚丁胺方法 ,联合组患者采用多巴酚丁胺联合去甲肾上腺素方法。比较两组患者的治疗效果、左心室射血分数(LVEF)、收缩压、舒张压、脑钠尿肽(BNP)、肌酐及尿量指标变化与不良反应发生率。结果联合组患者的治疗总有效率(94.1%)高于单一组(73.5%),差异有统计学意义(P<0.05)。两组患者治疗前的LVEF、收缩压、舒张压、BNP、肌酐及尿量指标比较,差异无统计学意义(P>0.05);两组治疗后的LVEF、收缩压、舒张压、尿量高于治疗前,BNP、肌酐低于治疗前,差异有统计学意义(P<0.05);治疗后,联合组患者的LVEF、收缩压、BNP、肌酐、尿量与单一组比较,差异无统计学意义(P>0.05);治疗后,联合组患者的舒张压高于单一组,差异有统计学意义(P<0.05)。联合组患者的不良反应总发生率为14.7%,低于单一组的41.2%,差异有统计学意义(P<0.05)。结论去甲肾上腺素联合多巴酚丁胺治疗心源性休克的效果较为理想,且具有较高的安全性,值得推广使用。
Objective To investigate the clinical effect of Norepinephrine combined with Dobutamine in the treatment of cardiogenic shock. Methods The 68 patients with cardiogenic shock admitted to our hospital from August 2016 to August 2018 were selected as subjects and were divided into the single group(34 cases) and combined group(34 cases) according to the method of random grouping. The single group used Dobutamine method. The combined group used Dobutamine combined Norepinephrine method. The results of treatment, left ventricular ejection fraction(LVEF), systolic blood pressure, diastolic blood pressure, brain natriuretic peptide(BNP), creatinine and urinary volume were compared with the incidence of adverse reactions. Results The total effective rate of treatment in the combined group was94.1%, which was higher than 73.5% in the single group, and the difference was statistically significant(P<0.05). There was no significant difference in LVEF, systolic blood pressure, diastolic blood pressure, creatinine and urine volume between the two groups before treatment(P>0.05). After treatment, the LVEF, systolic blood pressure, diastolic blood pressure and urine volume of the two groups were higher than that before treatment, while BNP and creatinine were lower than that before treatment, and the differences were statistically significant(P<0.05). After treatment, the LVEF, systolic blood pressure, BNP, creatinine and urine volume of patients in the combined group were compared with those in the single group, and the differences were not statistically significant(P>0.05). After treatment, the diastolic blood pressure of the combined group was higher than that of the combined group, and the difference was statistically significant(P<0.05). The total incidence of adverse reactions in the combined group(14.76%) was lower than that in the single group(41.2%), and the difference was statistically significant(P<0.05). Conclusion The effect of Norepinephrine combined with Dobutamine in the treatment of cardiogenic shock is ideal, and it has high safety and is worth promoting.
Objective To investigate the clinical effect of Norepinephrine combined with Dobutamine in the treatment of cardiogenic shock. Methods The 68 patients with cardiogenic shock admitted to our hospital from August 2016 to August 2018 were selected as subjects and were divided into the single group(34 cases) and combined group(34 cases) according to the method of random grouping. The single group used Dobutamine method. The combined group used Dobutamine combined Norepinephrine method. The results of treatment, left ventricular ejection fraction(LVEF), systolic blood pressure, diastolic blood pressure, brain natriuretic peptide(BNP), creatinine and urinary volume were compared with the incidence of adverse reactions. Results The total effective rate of treatment in the combined group was94.1%, which was higher than 73.5% in the single group, and the difference was statistically significant(P<0.05). There was no significant difference in LVEF, systolic blood pressure, diastolic blood pressure, creatinine and urine volume between the two groups before treatment(P>0.05). After treatment, the LVEF, systolic blood pressure, diastolic blood pressure and urine volume of the two groups were higher than that before treatment, while BNP and creatinine were lower than that before treatment, and the differences were statistically significant(P<0.05). After treatment, the LVEF, systolic blood pressure, BNP, creatinine and urine volume of patients in the combined group were compared with those in the single group, and the differences were not statistically significant(P>0.05). After treatment, the diastolic blood pressure of the combined group was higher than that of the combined group, and the difference was statistically significant(P<0.05). The total incidence of adverse reactions in the combined group(14.76%) was lower than that in the single group(41.2%), and the difference was statistically significant(P<0.05). Conclusion The effect of Norepinephrine combined with Dobutamine in the treatment of cardiogenic shock is ideal, and it has high safety and is worth promoting.
引文
[1]黄志新.左西孟旦和多巴酚丁胺治疗对急性心肌梗死并发心源性休克患者血清学指标的影响[J].海南医学院学报,2015,21(9):1191-1193,1197.
[2]延荣强,杨璇,李长江,等.多巴胺联合去甲肾上腺素治疗心源性休克的疗效及安全性分析[J].当代医学,2015,23(8):139-140.
[3]金光勇,林乐清,周梦露,等.去甲肾上腺素与多巴胺治疗心源性休克安全性的Meta分析[J].温州医科大学学报,2017,47(10):752-757.
[4]熊日成,俞宙,孙杰,等.多巴胺与去甲肾上腺素在心源性休克患者中的疗效探讨[J].中华老年多器官疾病杂志,2016,15(12):919-922.
[5]李炬带,刘力新,郭敏,等.去甲肾上腺素和多巴胺对心源性休克患者血流动力学和组织灌注氧代谢的影响[J].医学理论与实践,2015,28(23):3171-3173.
[6]郑浪宁,梁飘玲.参附注射液联合去甲肾上腺素治疗急性心肌梗死所致的心源性休克效果观察[J].河南医学研究,2017,26(10):1799-1800.
[7]余海波.多巴胺联合多巴酚丁胺在急性心肌梗死合并心源性休克患者中的救治体会[J].医药前沿,2015,5(35):166-167.
[8]杨立姮,张艳.多巴胺与去甲肾上腺素在心源性休克患者中的疗效探讨[J].饮食保健,2017,4(13):45-46.
[9]任丽芹.参麦注射联合去甲肾上腺素治疗心源性休克的疗效观察[J].中国保健营养,2016,26(6):282.
[10]李朋,李睿,邹永光,等.左西孟旦治疗急性心肌梗死并发心源性休克54例疗效评价[J].中国药业,2015,32(17):46-47.
[11]陈妍,刘寅.急性心肌梗死合并心源性休克的治疗进展[J].医学与哲学,2017,38(8):63-66.
[12]姑扎丽克孜·艾拜.多巴胺与去甲肾上腺素联合治疗心源性休克的疗效评价[J].中外女性健康研究,2017,22(9):102,117.
[13]袁伟峰,刘月娥,张梅,等.去甲肾上腺素联合多巴酚丁胺治疗感染性休克对患者血流动力学、血乳酸及CCr,FEH2O,FENa的影响[J].现代生物医学进展,2017,17(25):4852-4855.
[14]杨进军,蒋国燕.去甲肾上腺素联合多巴酚丁胺对感染性休克患者早期血乳酸及肾灌注的影响[J].实用临床医药杂志,2015,19(23):51-54.
[15]陈璐,钟惠娟.参附注射液联合去甲肾上腺素治疗心源性休克的临床研究[J].现代中西医结合杂志,2016,25(11):1203-1205.
[16]颜春悦,叶晓东,蒋龙元.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[J].中国医药科学,2017,7(9):72-74.
[17]高汉媛,史正刚,尚菁,等.菖蒲郁金汤对TS模型大鼠行为及纹状体单胺类神经递质的影响[J].西部中医药,2017,30(11):28-32.
[18]段艳,唐绍辉.扁鹊飞救远程急救系统对胸痛患者院前急救中的效果观察[J].中国医学装备,2017,14(10):83-86.
[19]姚剑锋,江均贤.多巴胺及去甲肾上腺素对脓毒性休克患者血流动力学的影响[J].中国医药科学,2018,8(15):226-228.
[20]徐芳芳.多巴胺配合多巴酚丁胺治疗小儿重症肺炎的效果及对细胞因子的影响[J].中国医药导报,2017,14(15):127-130.
[2]延荣强,杨璇,李长江,等.多巴胺联合去甲肾上腺素治疗心源性休克的疗效及安全性分析[J].当代医学,2015,23(8):139-140.
[3]金光勇,林乐清,周梦露,等.去甲肾上腺素与多巴胺治疗心源性休克安全性的Meta分析[J].温州医科大学学报,2017,47(10):752-757.
[4]熊日成,俞宙,孙杰,等.多巴胺与去甲肾上腺素在心源性休克患者中的疗效探讨[J].中华老年多器官疾病杂志,2016,15(12):919-922.
[5]李炬带,刘力新,郭敏,等.去甲肾上腺素和多巴胺对心源性休克患者血流动力学和组织灌注氧代谢的影响[J].医学理论与实践,2015,28(23):3171-3173.
[6]郑浪宁,梁飘玲.参附注射液联合去甲肾上腺素治疗急性心肌梗死所致的心源性休克效果观察[J].河南医学研究,2017,26(10):1799-1800.
[7]余海波.多巴胺联合多巴酚丁胺在急性心肌梗死合并心源性休克患者中的救治体会[J].医药前沿,2015,5(35):166-167.
[8]杨立姮,张艳.多巴胺与去甲肾上腺素在心源性休克患者中的疗效探讨[J].饮食保健,2017,4(13):45-46.
[9]任丽芹.参麦注射联合去甲肾上腺素治疗心源性休克的疗效观察[J].中国保健营养,2016,26(6):282.
[10]李朋,李睿,邹永光,等.左西孟旦治疗急性心肌梗死并发心源性休克54例疗效评价[J].中国药业,2015,32(17):46-47.
[11]陈妍,刘寅.急性心肌梗死合并心源性休克的治疗进展[J].医学与哲学,2017,38(8):63-66.
[12]姑扎丽克孜·艾拜.多巴胺与去甲肾上腺素联合治疗心源性休克的疗效评价[J].中外女性健康研究,2017,22(9):102,117.
[13]袁伟峰,刘月娥,张梅,等.去甲肾上腺素联合多巴酚丁胺治疗感染性休克对患者血流动力学、血乳酸及CCr,FEH2O,FENa的影响[J].现代生物医学进展,2017,17(25):4852-4855.
[14]杨进军,蒋国燕.去甲肾上腺素联合多巴酚丁胺对感染性休克患者早期血乳酸及肾灌注的影响[J].实用临床医药杂志,2015,19(23):51-54.
[15]陈璐,钟惠娟.参附注射液联合去甲肾上腺素治疗心源性休克的临床研究[J].现代中西医结合杂志,2016,25(11):1203-1205.
[16]颜春悦,叶晓东,蒋龙元.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[J].中国医药科学,2017,7(9):72-74.
[17]高汉媛,史正刚,尚菁,等.菖蒲郁金汤对TS模型大鼠行为及纹状体单胺类神经递质的影响[J].西部中医药,2017,30(11):28-32.
[18]段艳,唐绍辉.扁鹊飞救远程急救系统对胸痛患者院前急救中的效果观察[J].中国医学装备,2017,14(10):83-86.
[19]姚剑锋,江均贤.多巴胺及去甲肾上腺素对脓毒性休克患者血流动力学的影响[J].中国医药科学,2018,8(15):226-228.
[20]徐芳芳.多巴胺配合多巴酚丁胺治疗小儿重症肺炎的效果及对细胞因子的影响[J].中国医药导报,2017,14(15):127-130.