去甲肾上腺素和多巴胺治疗感染性休克效果对比及对SVRI、SvO_2、FENa和FEH_2O水平的影响

Comparison of effects of norepinephrine and dopamine on septic shock and their influence on SVRI, SvO_2, FENa and FEH_2O levels

目的探讨去甲肾上腺素(NA)和多巴胺(DA)治疗感染性休克效果对比及对全身血管阻力指数(SVRI)、混合静脉血氧饱和度(SvO_2)、滤过钠排泄分数(FENa)和滤过水排泄分数(FEH_2O)水平的影响。方法选取我院2015年2月~2018年2月收治感染性休克患者120例,按随机数字表法分为观察组及对照组,各60例。对照组采用微泵注入DA,观察组采用微泵注入NA。监控两组患者治疗前后SVRI、SvO_2、MAP三项血流动力学指标及乳酸清除率、FENa、FEH_2O三项相关指标,并记录治疗有效率。结果观察组治疗后总有效率(81.67%)明显高于对照组(63.33%),差异有统计学意义(P<0.05)。观察组治疗后SVRI、SvO_2、MAP水平高于对照组,差异有统计学意义(P<0.05)。观察组治疗后乳酸清除率、FEH_2O水平高于对照组,差异有统计学意义(P<0.05);FENa水平低于对照组,差异有统计学意义(P<0.05)。结论与DA相比,NA治疗感染性休克患者疗效更好,更有效稳定患者生命体征。

Objective To compare the efficacy of norepinephrine（NA） and dopamine（DA） in the treatment of septic shock and their influence on the systemic vascular resistance index（SVRI）, mixed venous oxygen saturation（SvO2）, and filtered sodium excretion fraction（FENa）, and filtered water excretion fraction（FEH2O） levels. Methods 120 patients with septic shock treated in our hospital from February 2015 to February 2018 were selected. According to the random number table method, they were divided into observation group and control group, with 60 cases in each group. The control group was treated with DA micro pump. The control group was treated with NA micro pump. The hemodynamic parameters of SVRI, SvO2, MAP, lactate clearance, FENa, and FEH2O before and after treatment in the two groups were monitored. And the treatment efficiency was recorded. Results The total effective rate （81.67%） in the observation group was significantly higher than that in the control group（63.33%）, and the difference was statistically significant（P〈0.05）. The SVRI, SvO2, and MAP levels in the observation group were higher than those in the control group after treatment, and the difference was statistically significant （P〈0.05）. The lactic acid clearance rate and FEH2O level in the observation group after treatment was significantly higher than that in the control group （P〈0.05）. The level of FENa was lower in the observation group than that in the control group, and the difference was significant （P〈0.05）. Conclusion Compared with DA, NA is more effective in treating patients with septic shock and is more effective in stabilizing patients＇ vital signs.