去甲肾上腺素、多巴胺对感染性休克患者胃黏膜pH值的影响  

Effect of Norepinephrine and Dopamine in the p H Value of Gastric Mucosa in Patiens with Septic Shock

作　　者：郭俊[1] 王夜明[1] 

机构地区：[1]湖北省新华医院,湖北武汉430015

出　　处：《中国医学创新》2015年第29期80-83,共4页Medical Innovation of China

摘　　要：目的:探讨去甲肾上腺素、多巴胺对感染性休克患者胃黏膜p H值(Phi)的影响。方法:选择64例感染性休克患者,按所使用的血管活性药物分为两组,A组为去甲肾上腺素组,B组为多巴胺组,每组各32例。观察用药前和用药后6 h血流动力学指标的改变,同时观察用药前和用药后6、12、24、48 h胃黏膜p H值的变化。结果:两组用药前血流动力学指标和胃黏膜p H值比较差异无统计学意义(P>0.05)。用药后6 h后,两组的平均动脉压(MAP)明显升高但差异无统计学意义(P>0.05);两组的中心静脉压(CVP)与中心静脉血氧饱和度(Scv O2)均升高,且A组高于B组,B组心率(HR)明显高于A组,两组比较差异均有统计学意义(P<0.05)。A组用药后6、12、24、48 h胃黏膜p H值均明显升高,治疗前后比较差异均有统计学意义(P<0.01),B组治疗前后比较差异无统计学意义(P>0.05)。结论:去甲肾上腺素、多巴胺均可改善感染性休克患者全身血流动力学状态,但去甲肾上腺素优于多巴胺,去甲肾上腺素较多巴胺可使胃黏膜p H值(Phi)明显升高。Objective：To investigate the effect of Norepinephrine and Dopamine in the pH value of gastric mucosa in patients with septic shock.Method：64 patients with septic shock were selected and divided into Norepinephrine treatment group（group A） and Dopamine treatment group（group B）,32 cases in each group.The change of hemodynamic index before and after medication 6 hours and the pH value of gastric mucosa before and after medication 6,12,24 and 48 hours were observed.Result：Before medication,the hemodynamic index and the pH value of gastric mucosa of two groups had no significant differences（P〉0.05）.After treatment,mean arterial pressure（MAP） of two groups significantly improved,but the difference was no statistically significant（P〉0.05）.The central venous pressure（CVP）and central venous oxygen saturation（ScvO2） of two groups were significantly improved and group A was higher than group B,heart rate of group B increased significantly than group A,the differences were statistically significant（P〈0.05）.The pH value of gastric mucosa after medication 6,12,24,and 48 hours in group A were significantly improved than before medication, the differences were statistically significant（P〈0.05）,there was no significant change of that in group B（P〉0.05）.Conclusion：Norepinephrine and Dopamine can all improve the whole body hemodynamic state in patients with septic shock,but Norepinephrine is better than Dopamine,Norepinephrine can improve the pH value of gastric mucosa than Dopamine.

关 键 词：去甲肾上腺素 多巴胺 感染性休克 胃黏膜PH值 

分 类 号：R459.7[医药卫生—急诊医学]