CAJ | 학술논문

目的:探讨不同剂量特立加压素( TP )对脓毒症难治性休克患者血流动力学的影响. 方法:选取本院收治的84例脓毒症难治性休克患者作为研究对象,按随机数字表分为大、小剂量组(每组42例) ,比较两组患者经不同剂量血管加压素输注后各组患者血流动力学的变化. 结果:两组患者经不同剂量血管加压素治疗后,平均动脉压(MAP)、心率(HR)、心脏指数(CI)、全身血管阻力(SVR)较治疗前相比均有显著改善,但两组改善程度无显著性差异( P>0.05) ,两组患者经治疗后休克指数均明显降低,排尿量显著增加,同时两组患者经治疗后乳酸清除率与混合静脉血液饱和度较治疗前相比均有改善,且改善程度基本一致( P>0.05). 结论:大小剂量的TP 治疗对于脓毒性难治性休克患者均有较好的疗效,但较大剂量血管加压素的使用与小剂量相比在血流动力学上并没有显著的差异,因此对于脓毒性难治性休克患者推荐使用在充分液体复苏的基础上,采用小剂量持续输入TP 同时联合去甲肾上腺素进行治疗.
목적:탐토불동제량특립가압소( TP )대농독증난치성휴극환자혈류동역학적영향. 방법:선취본원수치적84례농독증난치성휴극환자작위연구대상,안수궤수자표분위대、소제량조(매조42례) ,비교량조환자경불동제량혈관가압소수주후각조환자혈류동역학적변화. 결과:량조환자경불동제량혈관가압소치료후,평균동맥압(MAP)、심솔(HR)、심장지수(CI)、전신혈관조력(SVR)교치료전상비균유현저개선,단량조개선정도무현저성차이( P>0.05) ,량조환자경치료후휴극지수균명현강저,배뇨량현저증가,동시량조환자경치료후유산청제솔여혼합정맥혈액포화도교치료전상비균유개선,차개선정도기본일치( P>0.05). 결론:대소제량적TP 치료대우농독성난치성휴극환자균유교호적료효,단교대제량혈관가압소적사용여소제량상비재혈류동역학상병몰유현저적차이,인차대우농독성난치성휴극환자추천사용재충분액체복소적기출상,채용소제량지속수입TP 동시연합거갑신상선소진행치료.
Objective:To investigate the effect of the different dose of vasopressin on the hemodynamics of the patients with septic shock.Method:84 cases of patients with septic shock treated in our hospital were selected as the research group, which were individed into small dose group and high dose group.The hemo-dynamics of the two group was observed.Result:The mean arterial pressure ( MAP ) , heart rate ( HR) , car-diac index ( CI) and systemic vascular resistance ( SVR) of the two groups were significantly improved com-pared to before the treatment, but the improvement degree in the two groups had no significant difference ( P>0.05) .The shock index of the two groups were significantly lower,while the urine output was significantly increased, the clearance of lactic acid and mixed venous blood saturation were aslo improved after treatment, and the degree of improvement was almost the same (P >0.05).Conclusion: Small and high dose of TP therapy for patients with septic shock refractory both has good curative effect, but the high dose vasopressin has no significant difference in hemodynamic compared with small dose .Therefore septic patients with refrac-tory shock is recommended on the basis of fully liquid recovery with small dose of continuous input TP joint norepinephrine treatment.