肾上腺素联合苯海拉明在急诊救治重症过敏性休克中的作用

Effect of Epinephrine combined with Diphenhydramine in Emergency Treatment of Severe Anaphylactic Shock

目的探讨针对重症过敏性休克患者的急诊救治,应用肾上腺素联合苯海拉明的临床作用。方法选取2022年1月至2023年6月于贵州省建筑医院急诊救治的50例重症过敏性休克患者作为研究对象,根据用药方案不同分为对照组和联合组,各25例。对照组患者在常规急救措施基础上应用肾上腺素治疗,联合组患者在对照组基础上联用苯海拉明治疗,比较两组患者的治疗效果、各项生命体征指标恢复时间、治疗不同时刻心输出量及中心静脉压。结果联合组治疗有效率为92.00%,高于对照组的68.00%(P<0.05);联合组呼吸频率恢复时间、心率恢复时间、血压恢复时间、神志恢复时间、皮疹消退时间、苏醒时间短于对照组(P<0.05);治疗前两组心输出量、中心静脉压比较,差异无统计学意义(P>0.05);治疗后1、2、3、4h观察组心输出量多于对照组(P<0.05),中心静脉压高于对照组(P<0.05)。结论针对重症过敏性休克患者的急诊救治,应用肾上腺素联合苯海拉明临床效果良好,能促进患者神志、心率、血压等生命体征指征恢复,在提升心功能和循环功能方面具备协同增效作用。

Objective To explore the clinical effect of epinephrine combined with diphenhydramine in the emergency treatment of patients with severe anaphylactic shock.Methods Fifty patients with severe anaphylactic shock treated in the emergency department of Jianzhu Hospital of Guizhou Province from January 2022 to June 2023 were selected as the study objects,and were divided into control group and combination group according to different medication plans,with 25 cases in each group.The control group was treated with epinephrine on the basis of conventional emergency measures,and the combination group was treated with diphenhydramine on the basis of control group.The therapeutic effect,recovery time of various vital signs,cardiac output and central venous pressure at different time of treatment were compared between the two groups.Results The effective rate of combination group was 92.00%,which was higher than that of control group 68.00%(P<0.05).Respiratory rate recovery time,heart rate recovery time,blood pressure recovery time,consciousness recovery time,rash fading time and recovery time in combination group were shorter than those in control group(P<0.05).There was no significant difference in cardiac output and central venous pressure between the two groups before treatment(P>0.05).Cardiac output and central venous pressure in observation group were higher than control group at 1,2,3 and 4 h after treatment(P<0.05).Conclusion For the emergency treatment of patients with severe anaphylactic shock,the application of epinephrine combined with diphenhydramine has good clinical effect,can promote the recovery of patients'consciousness,heart rate,blood pressure and other vital signs,and has a synergistic effect on improving cardiac function and circulatory function.