连续多普勒无创血液动力学监测正性肌力药物对感染性休克患者心脏功能的影响  

Effect of Positive Inotropic Drugs on Cardiac Function in Patients with Septic Shock Monitored by Ultrasonic Cardiac Output Monitoring of Continuous Doppler

作　　者：汪伟平[1] 钟唯章 林巧燕 李光君 Wang Weiping;Zhong Weizhang;Lin Qiaoyan;Li Guangjun(Department of Critical Care Medicine,Xiamen Hospital of Traditional Chinese Medicine,Xiamen Fujian 361000,China)

机构地区：[1]厦门市中医院重症医学科,福建厦门361000

出　　处：《医疗装备》2021年第24期4-6,9,共4页Medical Equipment

摘　　要：目的探讨连续多普勒无创血液动力学(USCOM)监测多巴酚丁胺、肾上腺素对感染性休克患者心脏功能的影响。方法回顾性分析2019年7月至2020年7月厦门市中医院重症监护病房收治的64例感染性休克患者的临床资料,根据治疗方式的不同分为对照组(39例)和试验组(25例)。对照组给予多巴酚丁胺治疗,试验组给予肾上腺素治疗,两组治疗期间采用USCOM进行床边监测,比较两组血流动力学指标[每搏输出量(SV)、心输出量(CO)、校正流动时间(FTC)、外周血管阻力指数(SVRI)、氧输送(DO_(2))、心率(HR)、心肌收缩力(INO)及射血分数(EF)]。结果治疗后,两组CO、FTC、DO_(2)均优于治疗前,差异有统计学意义(P<0.05);但两组治疗后的CO、FTC、DO_(2)比较,差异均无统计学意义(P>0.05)。治疗后,试验组SV高于治疗前,且高于对照组,差异有统计学意义(P<0.05);治疗后,对照组HR高于治疗前,差异有统计学意义(P<0.05);试验组治疗前、后的HR比较,差异无统计学意义(P>0.05);但试验组治疗后的HR低于对照组,差异有统计学意义(P<0.05);两组治疗前后组内、组间的SVRI比较,差异均无统计学意义(P>0.05)。两组治疗前的INO、EF比较,差异均无统计学意义(P>0.05);治疗后,两组INO高于治疗前,且试验组高于对照组,差异有统计学意义(P<0.05);治疗后,两组EF比较,差异无统计学意义(P>0.05)。结论USCOM监测可指导临床医师应用多巴酚丁胺、肾上腺素治疗感染性休克患者,能够增加心肌收缩力,改善心功能,增加氧输送。Objective To investigate the effect of dobutamine and epinephrine on cardiac function in patients with septic shock by ultrasonic cardiac output monitoring of continuous Doppler.Methods The clinical data of 64 patients with septic shock admitted in the intensive care unit of Xiamen Hospital of Traditional Chinese from July 2019 to July 2020 were analyzed retrospectively.They were divided into control group(39 cases,treated with dobutamine)and experimental group(25 cases,treated with epinephrine)according to different treatment methods.The hemodynamic indexes were compared of the two groups,such as stroke volume(SV),cardiac output(CO),flow time corrected(FTC),systemic vascular resistance index(SVRI),oxygen delivery(DO_(2)),heart rate(HR),and inotropy(INO),ejection fraction(EF).Results After treatment,the SV in the experimental group was higher than that before treatment and higher than that the in control group,the difference was statistically significant(P<0.05).After treatment,Co,FTC and DO_(2)in the two groups were better than those before treatment(P<0.05);However,there was no significant difference in CO,FTC and DO_(2)between the two groups(P>0.05).After treatment,the HR of the control group was higher before treatment,the difference was statistically significant(P<0.05).There was no significant difference in HR between the two groups before and after treatment(P>0.05).There was no significant difference in SVRI between the two groups before and after treatment(P>0.05).There was no significant difference in the INO and EF between the two groups before treatment(P>0.05).After treatment,the INO were higher than before treatment of the two groups,and the INO in the experimental group was higher than that in the control group,the difference was statistically significant(P<0.05).After treatment,there was no significant difference in EF between the two groups(P>0.05).Conclusions Ultrasonic cardiac output monitoring of continuous Doppler can guide clinicians to treat septic shock patients with dobutamine and epineph

关 键 词：感染性休克 连续多普勒无创血液动力学 多巴酚丁胺 肾上腺素 

分 类 号：R459.7[医药卫生—急诊医学]