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去甲肾上腺素联合特利加压素治疗脓毒症休克患者的效果

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目的:探究去甲肾上腺素联合特利加压素治疗脓毒症休克患者的效果.方法:选取 2021 年 4 月—2022 年 4 月长沙市第一医院重症医学科收治的 87 例脓毒症休克患者.根据随机数表法将其分为对照组(43 例)和观察组(44 例).对照组给予去甲肾上腺素,观察组在对照组的基础上联合特利加压素治疗.比较两组去甲肾上腺素使用情况,输注前、输注12 h、输注 36 h的微循环指标,乳酸情况及不良反应.结果:维持治疗前,输注 12 h、24 h、36 h,两组去甲肾上腺素使用剂量逐渐降低,观察组去甲肾上腺素使用剂量均明显低于对照组,差异有统计学意义(P<0.05).输注 12 h、36 h,两组中心静脉血氧饱和度(central venous oxygen saturation,ScvO2)、氧耗(oxygen consumption,VO2)及氧输送(oxygen delivery,DO2)均升高,观察组ScvO2、VO2、DO2 均高于对照组,差异有统计学意义(P<0.05).治疗 3 d、7 d后,两组血乳酸水平均降低,观察组血乳酸水平明显低于对照组,乳酸清除率明显高于对照组,差异有统计学意义(P<0.05).观察组不良反应发生率(6.82%)显著低于对照组(25.58%),差异有统计学意义(P<0.05).结论:去甲肾上腺素联合特利加压素治疗脓毒症休克,可明显降低去甲肾上腺素的使用剂量,改善患者的微循环情况,降低血乳酸浓度,加快乳酸清除,减少不良反应的发生.
Effect of Norepinephrine Combined with Terlipressin in the Treatment of Septic Shock Patients
Objective:To explore the effect of Norepinephrine combined with Terlipressin in the treatment of septic shock patients.Method:A total of 87 patients with septic shock admitted to the Department of Intensive Care in Changsha First Hospital from April 2021 to April 2022 were selected.They were divided into control group(43 cases)and observation group(44 cases)according to random number table method.The control group was given Norepinephrine,and the observation group was treated with Terlipressin on the basis of the control group.The use condition of Norepinephrine,microcirculation indexes before infusion,12 h and 36 h of infusion,lactic acid condition and adverse reactions were compared between the two groups.Result:Before maintenance therapy,at 12 h,24 h,and 36 h of infusion,the dosage of Norepinephrine in the two groups gradually decreased,and the dosage of Norepinephrine in the observation group were significantly lower than those in the control group,the differences were statistically significant(P<0.05).At 12 h and 36 h of infusion,central venous oxygen saturation(ScvO2),oxygen consumption(VO2)and oxygen delivery(DO2)increased in both groups,ScvO2,VO2 and DO2 in the observation group were higher than those in the control group,and the differences were statistically significant(P<0.05).After 3 d and 7 d of treatment,the blood lactic acid level of both groups decreased,the blood lactic acid level of the observation group were significantly lower than those of the control group,and the lactic acid clearance rate was significantly higher than that of the control group,the differences were statistically significant(P<0.05).The incidence of adverse reactions in observation group(6.82%)was significantly lower than that(25.58%)in control group,and the difference was statistically significant(P<0.05).Conclusion:Norepinephrine combined with Terlipressin in the treatment of septic shock can significantly reduce the dosage of Norepinephrine,improve the microcirculation of patients,reduce blood lactate concentration,accelerate lactate clearance,and reduce the occurrence of adverse reactions.

Septic shockNorepinephrineTerlipressinLactate clearance

刘敏

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长沙市第一医院 湖南 长沙 410005

脓毒症休克 去甲肾上腺素 特利加压素 乳酸清除率

湖南省卫生健康委科研项目

B202317017605

2024

中外医学研究
中国医院管理杂志社

中外医学研究

影响因子:1.149
ISSN:1674-6805
年,卷(期):2024.22(8)
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