小剂量血管加压素联合多巴胺治疗感染性休克的临床疗效及安全性分析

Clinical efficacy and safety analysis of small dose of vasopressin combined with dopamine in treatment of septic shock

目的探讨分析小剂量血管加压素联合多巴胺治疗感染性休克的临床疗效及安全性分析。方法选取2014年5月‐2017年2月该院内科ICU收治的感染性休克患者149例为研究对象,按入院先后顺序将其分为研究组和对照组,其中,研究组患者液体复苏后泵入小剂量血管加压素联合多巴胺,对照组患者液体复苏后泵入多巴胺。对比观察两组患者应用血管活性药物前及用药6 h、12 h、24 h、48 h和72 h时心率(HR)、血压(BP)、尿量以及血乳酸含量,并计算乳酸清除率;记录分析两组患者在用药期间发生的不良反应(皮肤苍白、室性心律失常和水肿)。结果在临床疗效(心率、收缩压、尿量、血乳酸含量和乳酸清除率)方面研究组患者比对照组患者优势明显(P<0.05);研究组患者在用药期间皮肤苍白及水肿发生率为16.44%(12/73)及9.59%(7/73),均低于对照组患者的32.89%(25/76)及21.05%(16/76)(P<0.05);研究组患者在用药期间室性心律失常发生率为6.85%(5/73),略低于对照组患者的7.89%(6/76)(P>0.05)。结论小剂量血管加压素联合多巴胺在治疗感染性休克方面,疗效显著,且不良反应较少。

[Objective] To investigate the clinical efficacy and safety of low dose of vasopressin combined with dopamine in the treatment of septic shock. [Methods] A total of 149 patients with septic shock admitted to ICU in the department of internal medicine in our hospital from May 2014 to February 2017 were selected as the study objects and were divided into the study group and the control group according to the order of admission. The patients in the study group were treated with low dose vasopressin combined with dopamine after fluid resuscitation while the patients in the control group were pumped into dopamine after fluid resuscitation. The heart rate （HR）, blood pressure （BP）, urine volume and blood lactic acid content of the two groups were observed and compared before the application of vasoactive drugs and 6 hours, 12 hours, 24 hours, 48 hours and 72 hours after the administration of vasoactive drugs and the lactate clearance rate was calculated. And the adverse reactions （pale skin, ventricular arrhythmias and edema） were also recorded and analyzed during the medication period. [Results] The patients in the study group had obvious advantages over the control group in the clinical efficacy （heart rate, systolic blood pressure, urine volume, blood lactic acid content and lactate clearance rate） （P 〈0.05）. The incidences of skin pallor and edema during the medication period in the study group were respectively 16.44% （12/73） and 9.59% （7/73）, which were lower than 32.89% （25/76） and 21.05% （16/76） in the control group （P 〈0.05）. The incidence of ventricular arrhythmia in the study group was 6.85% （5/73）, which was slightly lower than 7.89% （6/76） of the control group （P 〉0.05）. [Conclusion] The curative effect of small dose of vasopressin combined with dopamine in the treatment of septic shock is remarkable and it has less adverse reactions.