参附注射液对感染性休克患者血流动力学及氧代谢影响的临床研究

Efficacy of the Shenfu injection on hemodynamic and oxygen metabolism in patients with septic shock

目的:探讨并比较使用参附注射液对阳气虚弱感染性休克患者疗治前后血流动力学及氧代谢的影响。方法:对符合阳气虚弱的感染性休克的22例患者进行早期目标指导治疗(Early Goal Directed Therapy,EGDT)后使用参附注射液并应用Swan-Ganz技术监测观察其前后中心静脉压(Central Venous Pressure,CVP)、心输出量(Cardiac Output,CO)、每搏输出量(Stroke Volume,SV)、体循环阻力(Systemic Vascular Resistance,SVR);肺动脉压力(Pulmonary Artery Pressure,PAP)、肺动脉嵌入压力(Pulmonary Embedded Pressure,PAWP)、肺循环阻力(Pulmonary Circulation Resistance,PVR);混合静脉血氧饱和度(Mixed Venous Oxygen Saturation,SvO2)、血乳酸(Lactic Acid,Lac);心率(Heart Rate,HR),外周血压(Peripheral Blood Pressure,MAP),经皮血氧饱和度(percutaneous blood oxygen saturation,SPO2),肤温(skin temperature,T)等的变化。结果:静滴参附注射液后Lac明显下降,SPO2显著上升,SvO2上升;SV显著增加,MAP、CVP回升,HR、PVR、SVR、T下降,CO开始回落;但PAP、PAWP仍高,尿量未见增加,上述差异均具有统计学意义。结论:对阳气虚弱的感染性休克患者静滴参附注射液后可以显著改善组织缺氧,有效改善及稳定循环,有一定的改善炎症作用,但在改善肺循环及肾功能效果欠佳。

Objective:To discuss and compare the Shenfu injection(参附注射液)on hemodynamic and oxygen metabolism in patients with septic shock of the Yangqi Xuruo(阳气虚弱)type.Methods:22 patients were given EGDT and the Shenfu injection.Applied Swan-Ganz technology monitoring,CVP,CO,SV,SVR and PAP,PAWP,PVR and SvO2,Lac,HR,MAP,SPO2,T and so on were observed.Results:After treatment,Lac was increased significantly,SPO2 was rise significantly,SVO2 was rising,SV was increased significantly,MAP and CVP was rebounded.HR,PVR,SVR,T was increased,CO was receded.PAP,PAWP was still high,urine output was not increase.the change was statistically significant differences.Conclusion:The Shenfu injection on septic shock of the Yangqi Xuruo type can improve hypoxia,effectively improve and stable circulation,improve inflammatory certain,without effect in improving pulmonary and renal function.