去甲肾上腺素治疗重症感染性休克患者的效果及其对血流动力学的影响分析

Analysis of effect of norepinephrine in the treatment of patients with severe septic shock and its influence on hemodynamics

目的探究去甲肾上腺素治疗重症感染性休克患者的效果及其对血流动力学的影响。方法选取2019年6月至2020年10月本院收治的68例重症感染性休克患者作为研究对象,根据治疗方案不同分为对照组与观察组,各34例。对照组给予多巴酚丁胺治疗,观察组在对照组基础上给予去甲肾上腺素治疗,比较两组治疗前后血流动力学指标[心率(HR)、心排出指数(CI)、平均动脉压(MAP)]、肾功能指标[肌酐清除率(Ccr)、血乳酸(LAC)、尿量]及临床疗效。结果治疗后,两组HR均慢于治疗前,CI、MAP均高于治疗前,且观察组HR慢于对照组,CI、MAP均高于对照组,差异有统计学意义(P<0.05);治疗后,两组LAC水平均低于治疗前,Ccr均高于治疗前,尿量均多于治疗前,且观察组LAC水平低于对照组,Ccr高于对照组,尿量多于对照组,差异有统计学意义(P<0.05);观察组治疗总有效率为94.12%,高于对照组的76.47%,差异有统计学意义(P<0.05)。结论去甲肾上腺素治疗重症感染性休克疗效确切,有利于稳定患者血流动力学,促进肾脏灌注改善。

Objective To explore the effect of norepinephrine in the treatment of severe septic shock and its influence on hemodynamics.Methods 68 patients with severe septic shock admitted to our hospital from June 2019 to October 2020 were selected as the research subjects,and they were divided into control group and observation group according to different treatment plans,with 34 cases in each group.The control group was given dobutamine treatment,and the observation group was given norepinephrine treatment on the basis of the control group.The hemodynamic indexes(heart rate[HR],cardiac output index[CI],mean arterial pressure[MAP]),renal function indexes(creatinine clearance[Ccr],blood lactic acid[LAC],urine volume)before and after treatment and clinical efficacy were compared between the two groups.Results After treatment,HR of the two groups was slower than that before treatment,CI and MAP were higher than those before treatment,and HR in observation group was slower than the control group,CI and MAP were higher than control group,the differences were statistically significant(P<0.05).After treatment,LAC level of the two groups was lower than before treatment,Ccr were higher than those before treatment,and urine volume were higher than those before treatment,the LAC level of the observation group was lower than that of the control group,Ccr was higher than that of the control group,and urine volume was higher than that of the control group,and the difference was statistically significant(P<0.05).Conclusion Norepinephrine is effective in the treatment of severe septic shock,which is beneficial to the stability of hemodynamics and the improvement of renal perfusion.