去甲肾上腺素联合多巴酚丁胺治疗心源性休克的临床效果

Clinical effect of Norepinephrine combined with Dobutamine in the treatment of cardiogenic shock

目的探讨去甲肾上腺素联合多巴酚丁胺治疗心源性休克的临床效果。方法选取2016年8月～2018年8月我院收治的68例心源性休克患者作为研究对象,按照随机分组方法将其分为单一组(34例)与联合组(34例)。单一组患者采用多巴酚丁胺方法 ,联合组患者采用多巴酚丁胺联合去甲肾上腺素方法。比较两组患者的治疗效果、左心室射血分数(LVEF)、收缩压、舒张压、脑钠尿肽(BNP)、肌酐及尿量指标变化与不良反应发生率。结果联合组患者的治疗总有效率(94.1%)高于单一组(73.5%),差异有统计学意义(P<0.05)。两组患者治疗前的LVEF、收缩压、舒张压、BNP、肌酐及尿量指标比较,差异无统计学意义(P>0.05);两组治疗后的LVEF、收缩压、舒张压、尿量高于治疗前,BNP、肌酐低于治疗前,差异有统计学意义(P<0.05);治疗后,联合组患者的LVEF、收缩压、BNP、肌酐、尿量与单一组比较,差异无统计学意义(P>0.05);治疗后,联合组患者的舒张压高于单一组,差异有统计学意义(P<0.05)。联合组患者的不良反应总发生率为14.7%,低于单一组的41.2%,差异有统计学意义(P<0.05)。结论去甲肾上腺素联合多巴酚丁胺治疗心源性休克的效果较为理想,且具有较高的安全性,值得推广使用。

Objective To investigate the clinical effect of Norepinephrine combined with Dobutamine in the treatment of cardiogenic shock. Methods The 68 patients with cardiogenic shock admitted to our hospital from August 2016 to August 2018 were selected as subjects and were divided into the single group (34 cases) and combined group (34 cases) according to the method of random grouping. The single group used Dobutamine method. The combined group used Dobutamine combined Norepinephrine method. The results of treatment, left ventricular ejection fraction (LVEF), systolic blood pressure, diastolic blood pressure, brain natriuretic peptide (BNP), creatinine and urinary volume were compared with the incidence of adverse reactions. Results The total effective rate of treatment in the combined group was 94.1%, which was higher than 73.5% in the single group, and the difference was statistically significant (P<0.05). There was no significant difference in LVEF, systolic blood pressure, diastolic blood pressure, creatinine and urine volume between the two groups before treatment (P>0.05). After treatment, the LVEF, systolic blood pressure, diastolic blood pressure and urine volume of the two groups were higher than that before treatment, while BNP and creatinine were lower than that before treatment, and the differences were statistically significant (P<0.05). After treatment, the LVEF, systolic blood pressure, BNP, creatinine and urine volume of patients in the combined group were compared with those in the single group, and the differences were not statistically significant (P>0.05). After treatment, the diastolic blood pressure of the combined group was higher than that of the combined group, and the difference was statistically significant (P<0.05). The total incidence of adverse reactions in the combined group (14.76%) was lower than that in the single group (41.2%), and the difference was statistically significant (P<0.05). Conclusion The effect of Norepinephrine combined with Dobutamine in the treatment of cardiogenic shock is ideal, and it has high safety and is worth promoting.