摘要
目的探讨小剂量垂体后叶素联合去甲肾上腺素治疗脓毒症休克的急性呼吸窘迫综合征(ARDS)的临床效果。方法采用随机数字表法将2019年7月-2020年10月因脓毒症休克所致的50例ARDS患者分为两组(每组50例),对照组采用常规治疗+去甲肾上腺素,观察组在对照组治疗基础上联合小剂量垂体后叶素,比较分析两组治疗效果。结果治疗前两组心率(HR)、平均动脉压(MAP)、氧合指数(PaO2/FiO2)水平无明显差异(P>0.05),治疗后观察组HR低于对照组,MAP、PaO2/FiO2高于对照组(P<0.05);治疗前两组白介素-6(IL-6)、白介素-1β(IL-1β)、肿瘤坏死因子-α(TNF-α)水平无明显差异(P>0.05),治疗后观察组IL-6、IL-1β、TNF-α水平低于对照组(P<0.05);治疗前两组N末端B型脑钠肽前体(NT-proBNP)、心肌肌钙蛋白T(cTnT)、血肌酐(Scr)水平无明显差异(P>0.05),经治疗复测,观察组NT-proBNP、cTnT、Scr水平均显著低于对照组(P<0.05);观察组去甲肾上腺素用量较对照组更低,机械通气时间、ICU住院时间较对照组短(P<0.05),两组不良反应发生率比较无明显差异(P>0.05)。结论临床治疗脓毒症休克ARDS采用小剂量垂体后叶素联合去甲肾上腺素有助于促进患者血流动力学、氧合功能改善,减轻炎症反应和重要器官功能损伤,减少去甲肾上腺素用量,加快恢复,且安全性高,值得推广。
Objective To investigate clinical effect of low-dose pituitrin combined with norepinephrine in treatment of acute respiratory distress syndrome(ARDS)in septic shock.Methods The paper chose 50 cases ARDS patients caused by septic shock from July 2019 to October 2020,and divided them into two groups(50 cases in each group)randomly.Control group was treated with routine therapy+noradrenaline,and observation group with low-dose pituitrin on the basis of control group.Curative effect was compared and analyzed between two groups.Results There was no significant difference in heart rate(HR),mean arterial pressure(MAP)and oxygenation index(PaO2/FiO2)between two groups before treatment(P>0.05).After treatment,HR in observation group was lower than control group,while MAP and PaO2/FiO2 were higher than control group(P<0.05).There was no significant difference in interleukin-6(IL-6)and interleukin-1β(IL-1β)before treatment,tumor necrosis factor-α(TNF-α)between two groups,(P>0.05).Levels of IL-6 and IL-1β,TNF-αin observation group were lower than control group after treatment(P<0.05).Before treatment,there was no significant difference between two groups in levels of NT proBNP,cardiac troponin T(cTnT),and serum creatinine(Scr)(P>0.05).After treatment and retest,levels of NT proBNP,cTnT,and Scr in observation group were significantly lower than control group(P<0.05);dosage of noradrenaline in observation group was lower than control group,duration of mechanical ventilation and ICU hospitalization was shorter than control group(P<0.05).There was no significant difference in incidence of adverse reactions between two groups(P>0.05).Conclusion Low-dose pituitrin combined with norepinephrine can improve hemodynamics and oxygenation function of patients in clinical treatment of septic shock ARDS,reduce inflammatory reaction and damage to important organ functions,reduce amount of norepinephrine,accelerate recovery with high safety,which is worthy of promtion.
作者
吕艺龙
LV Yilong(ICU Department,Shaoguan City Qujiang District People's Hospital,Shaoguan,Guangdong,512100)
出处
《智慧健康》
2022年第33期47-51,共5页
Smart Healthcare
