血管活性药物论文组织氧代谢论文：不同血管活性药物对感染性休克患者血流动力学和组织氧代谢的影响.docVIP

血管活性药物论文组织氧代谢论文：不同血管活性药物对感染性休克患者血流动力学和组织氧代谢的影响 [摘要] 目的 观察多巴胺（da）、去甲肾上腺素（ne）、去甲肾上腺素联合多巴酚丁胺（ne+dt）对感染性休克患者血流动力学和组织氧代谢的影响。方法 75例感染性休克患者随机分为3组，分别给予多巴胺、去甲肾上腺素、去甲肾上腺素联合多巴酚丁胺升压治疗，观察给药前及给药后1～6h的血流动力学指标[平均动脉压（map）、心率（hr）、肺毛细血管楔压（pcwp）、心排出量指数（ci）、体循环血管阻力指数（svri）]及组织氧代谢相关指标[混合静脉血氧饱和度（svo2）、早期乳酸清除率]的变化。结果 ①各组治疗后6h与治疗前比较，map、pcwp、ci、svri、svo2明显升高，hr及血乳酸值下降，差异有统计学意义；②各组同一时间点map、pcwp、svri差异均无统计学意义（p＞0.05）；③同一时间点da组hr明显高于其他两组（p＜0.05）而ne+dt组ci高于另外两组，差异有统计学意义（p＜0.05）；④3h ne及ne+dt组svo2值较da组明显增高（p＜0.01），乳酸值亦明显低于da组（p＜0.05）；⑤ne+dt组早期乳酸清除率高于另外两组。结论 各血管活性药物均能较好地改善感染性休克患者的血流动力学指标，去甲肾上腺素联合多巴酚丁胺在提高感染性休克患者的组织氧代谢方面优于单纯使用多巴胺或去甲肾上腺素，是感染性休克治疗的更好选择。 [关键词] 血管活性药物；感染性休克；血流动力学；组织氧代谢 the effect of different vasoactive drugs on hemodynamics and tissue oxygen metabolism in patients with septic shock wu haibin sun xiaocong huang he intensive care unit, the affiliated hospital of guangdong medical college, zhanjiang 524001, china [abstract] objective to observe the change of hemodynamics and tissue oxygen metabolism in patients with septic shock by dopamine（da）, norepinephrine （ne）, norepinephrine combined with dobutamine（ne + dt）. methods seventy-five patients with septic shock were randomly divided into 3 groups and were given da, ne, ne + dt respectively. the hemodynamics [mean arterial pressure （map）, heart rate（hr）, pulmonary capillary wedge pressure (pcwp), cardiac output index（ci）, systemic vascular resistance index （svri）] and oxygen metabolism related indicators [mixed venous oxygen saturation（svo2）, early lactate clearance rate] were detected before and after treatment. results （1） map, pcwp, ci, svri, and svo2 were significantly increased, while hr and blood lactate were decreased significantly in each group after treatment ;（2）there was no significant difference of map, pcwp and svri in each group at the same time（p＞0.05）;（3） the hr of da group was notablely higher than the other two groups（p＜0.05）and the ci of ne + dt group was conspicuously higher than the other two groups（p＜0.05）at the same