美托洛尔对脓毒性休克患者循环功能及氧代谢影响的临床研究  

作　　者：徐前程 查磊[1] 陈尚华[1] 刘小彬[1] 

机构地区：[1]皖南医学院附属芜湖市第二人民医院,241000

出　　处：《浙江临床医学》2016年第5期810-812,共3页Zhejiang Clinical Medical Journal

摘　　要：【摘要】目的评价美托洛尔对脓毒性休克患者循环功能及氧代谢的影响。方法脓毒性休克患者50例，分为观察组25例（M组）与对照组25例（C组）．M组予以美托洛尔12．5mg鼻饲，2次／d。C组使用生理盐水对照，观察两组患者治疗后循环指标及氧代谢指标的变化情况。结果血流动力性指标：M组与C组HR比较，6h后各时间点均明显降低（P〈0．01），与基线比较均明显下降（P〈0．05），C组与基线比较24h后时间点明显下降（P〈0．05）；两组患者MAP比较差异无统计学意义，与基线比较差异亦无统计学意义（P〉0．05）；M组较C组NE使用量差异无统计学意义（P〉0．05），与基线比48h后时间点使用量明显下降（P〈0．05），C组与基线比较差异无统计学意义（P〉0．05）；氧代谢指标：M组较C组ScvO2比较差异均无统计学意义（P〉0．05），与基线相比较96h时间点上升明显（P〈0．05），C组与基线相比均差异无统计学意义（P〉0．05）：M组与C组Lac治疗后比较，6h时间点降低明显（P〈0．05），余差异无统计学意义（P〉0．05），与基线相比各时间点均明显降低（P〈0．05），C组与基线Lac比较6h后时间点明显降低（P〈0．05）。PICCO指标：两组患者CI在各时间点差异无统计学意义（P〉0．05），与基线相比CI稍有下降趋势，但差异无统计学意义（P〉0．05）；两组患者dPmx在各时间点均差异无统计学意义（P〉0．05），与基线相比dPmx稍有下降趋势，但均差异无统计学意义（P〉0．05）；M组与C组SVI相比较6h后各时间点明显增加（P〈0．05），各时间点与基线相比明显上升（P〈0．05）．C组6h后时间点与基线相比较亦明显增加（P〈0．05）；M组与C组CVP比较6h后各时间点均明显下降（P〈0．05），与基线比较6h后时间点明显下降（P〈0．05），C组96h时间点与基线比较明显下降（P〈0．0Objective To observe the effect of metoprolol on the circulation function and oxygen metabolism in patients with septic shock conducted. Methods This is a prospective randomized controlled trial. Totally 50 patients marched the inclusion criteria and divided into two grouPs according to whether using metoprolol or not, each group contain 25 patients. Results The baseline was balance and comparable.The hemodynamic Parameters .Contrasted to C grouP, the HR of M group were slower after 6h, （ P〈0.01 ） .the HR of M group decreased significantly compared with baseline （P〈0.05） .the HR of control group decreased significantly compared with baseline after 24h; There was no statistical difference in MAP of two grouPs （P〉0.05 ） and compared with baseline, there also were not any statistically different （ P〉0.05 ） ; Contrasted to C group, the dosage of NE using in M grouP did not reduced significantly （ P〉0.05 ） and also did not reduced significantly when comPared with baseline at 72h and 96h （ P〈0.05, P〈0.01 ） .In C group did not reduced significantly contrasted to baseline too （P〉0.05 ） .The indexes of oxygen metabolism There were no statistical differences of ScvO2 between the two groups （P0.05 ） .ComPared with the baseline, the ScvO2 of M group was significant higher （ P〈0.05 ） , but there were no statistical differences in control grouP at each time Point （P0.05 ） .After treatment, the Lac of M group reduced significantly compared with baseline （ P〈0.05 ） and reduced obviously contrasted to C grouP at 6h （ P〈0.05 ） , comPared with baseline C group decreased significantly after 6h （ P〉0.05 ） .For the PICCO indexes, there were no statistical differences of CI and dPmx at each time point between the two grouPs （P〉0.05 ） ; ComPared with baseline, the SVI of M group increased obviously and also increased significantly when contrasted to C grouP after 6h.The SVI of C grouP also increased at each time Point after 6h; ComPared with baseline and

关 键 词：脓毒性休克 美托洛尔 循环功能 氧代谢 

分 类 号：R631.4[医药卫生—外科学]