摘要
目的:探讨ICU重症感染性休克患者给予去甲肾上腺素微量泵入治疗对血流动力学、炎性因子水平及预后的影响。方法:选取收治的66例ICU重症感染性休克患者,采用随机摸球法分为A组和B组各33例,B组给予多巴胺微量泵入治疗,A组加用去甲肾上腺素微量泵入治疗,比较两组血流动力学、炎性因子水平、预后情况、肾功能指标、降钙素原(PCT)和乳酸(LA)水平。结果:两组治疗后平均动脉压(MAP)、中心静脉压(CVP)比治疗前明显升高且A组明显高于B组,心率(HR)比治疗前明显降低且A组明显低于B组,差异均有统计学意义(P<0.05)。治疗后两组白细胞介素-8(IL-8)、肿瘤坏死因子-α(TNF-α)、超敏C-反应蛋白(hs-CRP)水平比治疗前明显降低,且A组明显低于B组,差异均有统计学意义(P<0.05)。两组治疗后急性生理与慢性健康状况Ⅱ(APACHEⅡ)评分比治疗前明显降低,且A组明显低于B组,差异均有统计学意义(P<0.05)。治疗后A组血尿素氮(BUN)、血肌酐(SCr)水平比治疗前明显降低,且A组明显低于B组,差异均有统计学意义(P<0.05)。治疗后两组PCT、LA水平比治疗前明显降低,且A组明显低于B组,差异均有统计学意义(P<0.05)。结论:ICU重症感染性休克患者给予去甲肾上腺素微量泵入治疗,能够改善血流动力学指标,对炎性因子水平有显著调节作用,还可促使肾功能恢复,降低PCT、LA水平。
Objective To investigate the effects of micropumping of norepinephrine on hemodynamics, inflammatory factors and prognosis in ICU patients with severe septic shock.Method A total of 66 ICU patients with severe septic shock were selected and randomly divided into two groups by ball-touch method: group A(n=33) and group B(n=33). Group B was treated with dopamine micropump, and group A was treated with norepinephrine micropump. The levels of hemodynamics, inflammatory factors, prognosis, renal function, procalcitonin(PCT) and lactic acid(LA) were compared between the two groups.Results After treatment, mean arterial pressure(MAP) and central venous pressure(CVP) in both groups were significantly increased, and heart rate(HR) was significantly decreased(P<0.05). Compared with group B, MAP and CVP in group A were significantly higher(P<0.05), and HR was significantly lower(P<0.05). After treatment, the levels of interleukin-8(IL-8), tumor necrosis factor-α(TNF-α) and hypersensitive C-reactive protein(HS-CRP) in both groups were significantly decreased(P<0.05), and the levels in group A were significantly lower than that in group B(P<0.05). After treatment, the scores of acute physiology and chronic health status Ⅱ(APACHE Ⅱ) in both groups were significantly decreased(P<0.05), and the scores of group A were significantly lower than that of group B(P<0.05). After treatment, the levels of blood urea nitrogen(BUN) and blood creatinine(SCr) in group A were significantly decreased(P<0.05), and those in group A were significantly lower than those in group B(P<0.05). The levels of PCT and LA in the two groups were significantly decreased after treatment(P<0.05), and the levels in group A were significantly lower than that in group B(P<0.05). Conclusion Micropumping of norepinephrine in ICU patients with severe septic shock can improve hemodynamic indexes, significantly regulate the levels of inflammatory factors, promote the recovery of renal function, and reduce the levels of PCT and LA.
作者
冯俊
杨正光
黄诚军
FENG Jun;YANG Zheng-guang;HUANG Cheng-jun(Department of critical medicine,Nanping first hospital,Nanping 353000,China)
出处
《吉林医学》
CAS
2022年第9期2415-2418,共4页
Jilin Medical Journal
