去甲肾上腺素对肝移植术后早期血流动力学的影响

The effect of norepinephrine on the hemodynamics in the early phase of post liver transplantation

目的 研究去甲肾上腺素对肝移植术后早期异常血流动力学状态 (高排低阻 )的影响。方法 对肝移植术后即刻周围血管阻力 <10mN·s·cm-5的患者通过微量注射泵持续 2 4h给予去甲肾上腺素 ,观察其血流动力学和氧合代谢指标。结果 给予去甲肾上腺素的治疗组自治疗 1h起平均动脉压和周围血管阻力即明显高于治疗前和对照组 (常规治疗者 )相应时刻数值 ,但未超出正常值范围 ,氧摄取率也自治疗 1h起明显升高 ;治疗组的心率、心输出量、肺血管阻力和每小时尿量等均未发生明显变化。结论 去甲肾上腺素可纠正肝移植术后早期高排低阻的异常血流动力学状态 。

Objective To study the effect of norepinephrine (NE) on the abnormal hemodynamic status of high output low resistance in the early phase of post liver transplantation.Methods The 12 post liver transplantation patients with systemic vascular resistance (SVR) <10 mN·s·cm -5 were randomly divided into two groups: NE-treated group and control group with routine treatment. The indexes of hemodynamics and oxygenation metabolism were observed.Results The mean artery pressure (MAP), SVR and oxygen extraction (O 2EXT) were significantly increased 1 h after treatment in the NE-treated group than the base line and that in the control group, but the levels were in the normal range. The heart rate, cardiac output, pulmonary vascular resistance and urine output per h had no significant change in the NE-treated group.Conclusions NE can correct the abnormal hemodynamic status of high output low resistance in the early phase of post liver transplantation and can improve the tissue oxygenation.