早期应用不同剂量山莨菪碱治疗感染性休克血管外肺水疗效及安全性研究  

Effects and safety of different anisodamine doses on EVLW at early stage of septic shock patients

作　　者：王日兴[1] 林明强[1] 林家聪[1] 

机构地区：[1]海南省海南医学院第2附属医院急诊科,海南海口570311

出　　处：《海南医学院学报》2017年第7期901-903,共3页Journal of Hainan Medical University

基　　金：中国高校医学期刊临床专项资金项目(11221022)~~

摘　　要：目的:探讨不同剂量山莨菪碱对感染性休克血管外肺水的影响及安全性。方法:我院重症监护室63例感染性休克患者,按山莨菪碱的用量随机分为对照组20例(C组,未用山莨菪碱),常规剂量组25例(N组,山莨菪碱20~40 mg/日),超大剂量组(H组,山莨菪碱80 mg/日),观察T、HR、氧合指数、CI、ITBVI、EVLWI变化。结果:治疗12h后,超大剂量组出现CI、ITBVI升高,EVLWI下降,但同时T升高,HR升高,氧合指数下降,患者不能耐受,终止实验。N组血管外肺水指数(EVLWI)、肺血管通透性指数(PVPI)、心指数(CI),胸腔内血容量指数(ITBVI),氧合指数改善明显优于C组,病死率减少,差异均具有统计学意义(P<0.05)。结论:常规剂量山莨菪碱能够降低感染性休克血管外肺水,改善患者预后,不推荐超大剂量山莨菪碱治疗感染性休克。Objective：To investigate the effects and safety of different anisodamine doses on EVLW at early stage of septic shock patients.Method：A total of 63 patients with septic shock were enrolled in ICU,and they were randomly divided into control group（C group,20cases）,normal anisodamine doses group[N group,25 cases,anisodamine（20~40）mg/d],high anisodamine doses group[H group,18 cases,anisodamine（20~40）mg/d].the dynamic changes of temperature（T）,heart rate（HR）,oxygenation index（OI）,cardiacindex（CI）,intrathoracic blood volume index（ITBVI）,extra-vascular lung water index（EVLWI）were observed.Results：Twelve hours after treatment,compared with C and N group,CI and ITBVI significantly increased in H group,EVLWI significantly decreased in H group.Meanwhile,T and HR significantly increased in H group,oxygenation index significantly decreased in H group.Some patients are unable to tolerate anisodamine treatment which leads to cessation of experiment.Compared with C group,EVLWI,PVPI,CI,ITBVI,oxygenation index significantly improved in N group（P〈0.05）,mortality rates significantly decreased（P〈0.05）.Conclusions：Normal anisodamine doses would significantly decreased EVLWI and significantly improved outcomes,high anisodamine doses is not recommended on EVLWI in patients with septic shock.

关 键 词：山莨菪碱 感染性休克 血管外肺水指数 

分 类 号：R631.4[医药卫生—外科学]