摘要
目的 :比较小剂量多巴胺及多巴酚丁胺对心脏手术后低心排综合征患者血流动力学和氧代谢的影响。方法 :12例心脏手术后低心排患者分别持续静脉泵入 5～ 10 μg·min- 1 ·kg- 1 多巴胺或多巴酚丁胺 ,观察血流动力学和氧代谢的改变。结果 :与给药前相比 ,10 μg·min- 1 ·kg- 1多巴胺和 5～ 10 μg·min- 1 ·kg- 1 多巴酚丁胺给药后均能显著提高心脏指数 (CI) ,但同样使CI增加5 0 %～ 70 % ,多巴酚丁胺只需 5 μg·min- 1 ·kg- 1 ,而多巴胺需要 10 μg·min- 1 ·kg- 1 。 5～ 10 μg·min- 1 ·kg- 1 多巴酚丁胺使体血管阻力指数 (SVRI)和肺动脉嵌顿压 (PAWP)显著降低 ,而多巴胺对SVRI和PAWP无显著影响 ,两者对肺动脉压 (PAP)和肺血管阻力指数 (PVRI)均无显著影响。5～ 10 μg·min- 1 ·kg- 1 多巴酚丁胺均导致氧输送指数 (DO2 )和氧耗指数 (VO2 )显著提高 ,但 5～10 μg·min- 1 ·kg- 1 多巴胺对DO2 和VO2 无明显影响。结论 :与多巴胺相比 ,多巴酚丁胺更为有效的提高CI和DO2 、降低心脏前后负荷 ,有助于改善组织缺氧。
Aim:To compare the hemodynamic and oxygen metabolism effects of low dose dobutamine and dopamine in postcardiotomy patients with low cardiac output syndrome.Methods:12 postcardiotomy patients with low cardiac output syndrome were randomized to receive an infusion of low dose dopamine and dobutamine,and collected data of hemodynamic and oxygen metabolism were studied.Results:As compared with baseline,dopamine(10μg·min -1 ·kg -1 )and dobutamine(5μg·min -1 ·kg -1 )increased cardiac index(CI)markedly.CI increased 50%～70% by 10μg·min -1 ·kg -1 dopamine,but only by 5μg·min -1 ·kg -1 dobutamine.Dobutamine decreased pulmonary arterial wedge pressure,systemic vascular resistance index and increased oxygen delivery index,oxygen consumption index,but dopamine had no effect on these parameters.Both dopamine and dobutamine had no effect on pulmonary arterial pressure and pulmonary vascular resistance index.Conclusion:Compared with dopamine,dobutamine improved cardiac index,preload and afterload,and tissue oxygenation significantly.
出处
《急诊医学》
CSCD
1999年第2期82-84,共3页
