亚甲蓝与去甲肾上腺素治疗心脏外科术后血管麻痹综合征的疗效分析

Efficacy Analysis of Methylene Blue and Norepinephrine in the Treatment of Vasoparalysis Syndrome after Cardiac Surgery

目的探讨亚甲蓝与去甲肾上腺素治疗心脏外科术后血管麻痹综合征的疗效。方法对该院2019年7月—2021年3月行心脏外科手术后出现血管麻痹综合征的50例展开研究,以随机数表法分为对照组和研究组,各25例。对照组给予去甲肾上腺素治疗,研究组则给予亚甲蓝治疗。观察两组不同时间点血流动力学变化、氧代谢变化及不良反应发生情况。结果两组患者血压维持稳定,与对照组比较,当SVR下降<30%时,研究组MAP T_(2)时增加与对照组T_(2)时增加差异无统计学意义(P﹥0.05),当SVR下降≥30%时,亚甲蓝联合去甲肾上腺素治疗后需要量T_(2~4)明显降低,差异有统计学意义(P<0.05);HR T_(2~3)时显著降低,差异有统计学意义(P<0.05)。于T_(2)时,两组O_(2) ER、VO_(2)I均有增加,DO_(2)1下降,且研究组O_(2) ER、VO_(2)I分别为(23.60±0.84)%、(118.60±10.84)mL/(min·m^(2))均高于对照组,DO_(2)1(428.42±21.08)mL/(min·m^(2))低于对照组,差异有统计学意义(P<0.05),但两组SvO_(2)各时段相比差异无统计学意义(P>0.05)。结论亚甲蓝治疗心脏外科术后血管麻痹综合征时改善MAP效果与去甲肾上腺素治疗效果关性良好,SVR明显降低时亚甲蓝联合去甲肾上腺素治疗心脏外科术后血管麻痹综合征效果显著,亚甲蓝在该病血流动力学稳定中发挥至关重要的作用。

Objective To investigate the efficacy of methylene blue and norepinephrine in the treatment of vasoparalysis syndrome after cardiac surgery.Methods A study was conducted on 50 cases of vascular palsy syndrome after cardiac surgery in the hospital from July 2019 to March 2021.The random number table was used to divide them into a control group and a study group with 25 cases each.The control group was given norepinephrine treatment,and the study group was given methylene blue treatment.Observed the changes of hemodynamics,oxygen metabolism and the occurrence of adverse reactions in the two groups at different time points.Results The blood pressure of the two groups of patients remained stable.Compared with the control group,when SVR decreased<30%,there was no statistically significant difference between the increase in MAP T_(2) in the study group and the increase in T_(2) in the control group(P>0.05).When SVR decreased by≥30%,the required T_(2-4) was significantly reduced after methylene blue combined with norepinephrine treatment,and the difference was statistically significant(P<0.05).HR T_(2-3) was significantly reduced,and the difference was statistically significant(P<0.05).At T_(2),both groups of O_(2) ER and VO_(2)I increased,and DO_(2)1 decreased.Moreover,the O_(2) ER and VO_(2)I of the study group were(23.60±0.84)%and(118.60±10.84)mL/(min·m^(2)),respectively,higher than those of the control group,and DO_(2)1(428.42±21.08)mL/(min·m^(2))lower than the control group,the difference was statistically significant(P<0.05).However,the difference in SvO_(2) between the two groups was not statistically significant(P>0.05).Conclusion The effect of methylene blue in the treatment of vasoparalysis syndrome after cardiac surgery is related to the effect of norepinephrine.When SVR is significantly reduced,methylene blue combined with norepinephrine has a significant effect on the treatment of vasoparalysis syndrome after cardiac surgery.Methylene blue plays a vital role in the hemodynamic stability of the disease.