参附注射液对休克患者血流动力学和多巴胺剂量的干预性研究.docVIP

参附注射液对休克患者血流动力学和多巴胺剂量的干预性研究 吕国焰1 卓道勤1 熊尚全2 作者单位：1.湖北省襄阳市中医医院ICU 湖北 襄阳 441000； 2.福建中医药大学附属人民医院心内科 福建 福州 350000； 通讯作者：吕国焰，1981，男，主治医师 Email：moving2008@ 【摘要】 目的 探讨参附注射液对休克患者血流动力学、多巴胺剂量及临床疗效的影响。方法 将47例休克患者随机分为对照组（22例）和参附组（25例），分别应用常规抗休克治疗和在常规治疗基础上加用参附注射液，应用Swan-Ganz导管监测用药前、用药后0.5h、1h、2h、4h、8h、12h、16h、20h和24h各个时间点的血流动力学指标，记录多巴胺剂量，观察临床疗效。结果 治疗8小时后参附组维持相同水平血压（≥65mmHg）所需多巴胺剂量[（12.15±4.33））））））[ Abstract ] Objective To explore the effect of Shenfu Injection on hemodynamics in patients with shock, dopamine and clinical curative effect. Methods 47 cases of shock patients were randomly divided into control group ( n = 22) and Shenmai group (n = 25 ), respectively, the application of conventional anti-shock treatment and on the basis of conventional therapy plus Shenfu injection, application of Swan-Ganz catheter monitoring before treatment, after administration of 0.5h, 1H, 2h, 4h, 8h, 12h, 16h, 20h and 24h all time points of hemodynamic indices, recording of dopamine dose, observation of clinical efficacy. Results of treatment after 8 hours of Shenfu group maintain the same level of blood pressure ( 65mmHg ) required for the dopamine dose [ ( 12.15 + 4.33) UG / kg / min] than the control group [ ( 13.08 + 3.60) UG / kg / min] reduce, after 12 hours of Shenfu group SVI [ ( 44.35 + 3.57) ml / m2], CI [ ( 2.79 + 2.05) L / min / m2] than the control group [ ( 42.22 + 2.08) ml / m2, ( 2.56 + 1.12) L / min / m2] increased, HR [ ( 108.52 + 7.35) BPM], SVRI [ ( 1865 + 558.38) dynes / sec / CM-5 / m2] than the control group [ ( 112.05 + 7.44) BPM, ( 1998.95 + 603.50) dynes / sec / CM-5 / m2] reduced, within 24 hours of the rescue success rate ( 68%) than the control group ( 59.09%) improve. Conclusion Shenfu Injection on shock patients cardiac output and blood pressure effects may be primarily based on the stroke volume is increased, but not heart rate increases quickly and the loop resistance increased; but the intravenous application of Shenfu Injection onset may still slower