重症感染性休克患者去甲肾上腺素联合纳洛酮治疗对CI、MAP、CVP、SpO_(2)、SvO_(2)的影响

Effect of norepinephrine combined with naloxone on CI,MAP,CVP,SpO_(2),SvO_(2) in patients with severe septic shock

目的探究重症感染性休克患者去甲肾上腺素联合纳洛酮治疗对心脏指数(CI)、平均动脉压(MAP)、中心静脉压(CVP)、动脉血氧饱和度(SpO_(2))、静脉血氧饱和度(SvO_(2))的影响。方法选取2018年3月至2020年4月该院收治的重症感染性休克患者102例,随机分成两组,每组51例,对照组进行去甲肾上腺素治疗,研究组采用去甲肾上腺素联合纳洛酮治疗。观察对比两组患者的临床治疗效果、乳酸(LA)水平、炎症因子水平及肾功能、血流动力学指标的变化情况。结果研究组的治疗效果明显优于对照组(P<0.05);研究组的LA和C反应蛋白(CRP)、降钙素原(PCT)等炎症因子水平均低于对照组(P<0.05);研究组的肾功能指标均明显优于对照组(P<0.05);研究组的血流动力学指标均明显优于对照组(P<0.05)。结论在重症感染性休克患者的临床治疗中应用去甲肾上腺素联合纳洛酮治疗,能够降低患者机体内的LA和炎症因子水平,缓解炎性反应,改善肾功能指标,以及优化机体内的CI、MAP和CVP、SpO_(2)及SvO_(2)等多种血流动力学指标,具有比较理想的治疗效果,值得推广应用。

Objective To investigate the effects of norepinephrine combined with naloxone on cardiac index(CI),mean arterial pressure(MAP),central venous pressure(CVP),oxygen saturation(SpO_(2))and venous oxygen saturation(SvO_(2))in patients with severe septic shock.Methods A total of 102 patients with severe septic shock admitted to the hospital from March 2018 to April 2020 were randomly divided into two groups with 51 patients in each group.The control group was treated with norepinephrine,while the study group was treated with norepinephrine combined with naloxone.The changes of clinical treatment effect,lactic acid(LA)level,inflammatory factor level,renal function and hemodynamic indexes were observed and compared.Results The therapeutic effect in the study group was significantly higher than that in the control group(P<0.05).The levels of LA,C-reactive protein(CRP),procalcitonin(PCT)and other inflammatory factors in the study group were lower than those in the control group(P<0.05).The renal function indexes in the study group were significantly better than those in the control group(P<0.05).The hemodynamic indexes in the study group were significantly better than those in the control group(P<0.05).Conclusion In the clinical treatment of patients with severe septic shock,norepinephrine combined with naloxone can reduce the concentration of LA and the level of inflammatory factors,and reduce the inflammatory reaction,improve the renal function indexes and the hemodynamic indexes,such as CI,MAP,CVP,SpO_(2)and SvO_(2),which has the ideal treatment effect,and is worthy of popularization and application.