小剂量多巴胺在治疗新生儿窒息后肾损害中的应用评价

Evaluation of A Small Dose of Dopamine in the Treatment of Neonatal Postasphyxial Renal Damage

目的探讨小剂量多巴胺在治疗新生儿窒息后肾损害中应用评价。方法 2009年1月至2012年1月收治的中重度新生儿窒息伴肾损害166例,分为常规治疗组80例,治疗组86例观察临床效果。结果经统计学分析,两组治疗前血Bun、Cr比较P>0.05差异无显著性;两组治疗72h、治疗7d血Bun、Cr比较P<0.05差异有显著性。常规组总有效率71.25%低于治疗组总有效率96.51%。经统计学分析P<0.05差异有显著性。结论多巴胺是体内合成一种内源性儿茶酚胺,具有大剂量应用收缩血管、升高血压,当小剂量2～5μg/min时,作用多巴胺受体,对内脏血管起到扩张作用,扩张肾血管,解除肾血管收缩,可使肾血流量增加,肾小球滤过率增加,减少肾实质性损害,改善肾脏功能。总之,在对中重度新生儿窒息在复苏后充分补充血容量基础上,应用小剂量多巴胺可以改善肾灌注,增加肾血流量,改善肾脏功能。

Objective To study on low dose of dopamine in the treatment of neonatal postasphyxial renal damage evaluation. Methods The 2009-01-2012-01 were in severe neonatal asphyxia complicated with renal injury in 166 cases, divided into routine treatment group of 80 cases, the treatment group of 86 cases observation of clinical effect. Results Statistical analysis, two groups of patients before blood Bun, P〉0.05 there is no significant difference between two groups of treatment; 72h, Bun, Cr treatment 7d blood P〈0.05 there were significant differences. The conventional group total effective rate 71.25% lower in the treatment group total effective rate 96.51% statistically significant difference of P〈0.05. Conclusion Dopamine is the in vivo synthesis of an endogenous catecholamines, with large dose of blood vessels, increased blood pressure, when the small dose of 2-5~g/min, role of dopamine receptors, on splanchnic vessel has an expanding function, renal vascular expansion, relieve renal vasoconstriction, the increase in renal blood flow, glomerular filtration rate increased, decreased renal substantial damage, improve renal function. In short, in severe neonatal asphyxia after resuscitation in a full complement of blood volume basis, using small dose dopamine can improve renal perfusion, increased rcnal blood flow, improve renal function.