特利加压素联合去甲肾上腺素在感染性休克中的应用.docVIP

精品论文 参考文献 特利加压素联合去甲肾上腺素在感染性休克中的应用 朱刚刘丽 　　安徽省宿州市立医院ICU安徽宿州234000 　　【摘要】 　　目的:探讨特利加压素(TP)联合去甲肾上腺素（NE）对感染性休克患者血流动力学及乳酸清除率的影响。方法:感染性休克患者22例，随机分为对照组（10例）和试验组（12例），分别给予NE和NE+TP治疗，观察用药前(T0)，用药后6h(T6)，48h（T48）患者的心率(HR)、平均动脉压(MAP)、血乳酸清除率、心脏指数(CI)、血管外肺水指数（EVLW）以及全身血管阻力(SVR)。结果：(1)与T0比较，T6～T48时2组患者的MAP、乳酸清除率明显升高，HR明显下降(P＜005)(2)2组去甲肾上腺素剂量在治疗后6h逐步下调，至观察结束试验组使用剂量明显低于对照组(P＜005)，两组的心脏指数(CI)、血管外肺水指数（EVLW）以及全身血管阻力(SVR)无明显差异(Pgt;005)。结论：在感染性休克患者中，小剂量持续输注TP联合NE，能有效改善其血流动力学，降低血乳酸水平和去甲肾上腺素的使用剂量。 　　【关键词】感染性休克；特利加压素；去甲肾上腺素 　　The effects of the terlipressin combined with norepinephrine on septic shock 　　ZHU GangLIU Li 　　et al. Department of intensive care unit,Su zhou Municipal Hospital,Anhui230000,china 　　【Abstract】 　　Objective:To investigate the effects of low dose continuous infusion terlipressin(TP)combined with norepinephrine(NE)on hemodynamic variables and clearance rate of blood lactate in patients with septic shock．Methods:22 patients with septic shock were divided into control group(10cases)and experiment group(12cases),NE was used in control group,and the lowdose continuous infusion of TP combined with NE was used in experiment group.Serial measurements of HR、MAP、clearance rate of blood lactate、CI、EVLW and SVR were made before infusion(T0),after infusion at 6 hours(T6),12hours(T12),24hours(T24)and48 hours(T48). Results:(1)after 6 hours of treatment，MAP、clearance rate of blood lactate of the two groups were increased significantly，HR was decreased (P＜005)(2)The dose of norepinephrine were gradually reduced afart treatment,to the end the dose of experiment group was significantly lower than the control group(P lt; 005),but there were no significant difference between the two groups of cardiac index、extravascular lung water and systemic vascular resistance .Conclusion For the patients with septic shock，lowdose continuous infusion terlipressin combined with norepinephrine can effectively improve hemodynamics，decrease blood lactate and doze of norepinephrine. 　　【Key words】Sept