摘要:
目的 观察左西孟旦注射液治疗结核性心包炎心包剥脱术后患者的临床疗效和安全性.方法 将42例结核性心包炎心包剥脱术后的患者随机分为对照组20例和试验组22例.对照组予以静脉泵入多巴酚丁胺2 μg·kg-1 ·min-1,1h后增加到4μg· kg-1·min-1并持续23 h;试验组予以静脉泵入西孟旦注射液,负荷量为12μg·kg-1,注射时间10 min,随后予以静脉泵入0.1μg·kg-1·min-,1h后增加到0.1~0.2μg·kg-1 ·min-1持续23 h.2组均给药1次.比较2组患者临床获益率血管活性药物使用、机械通气及ICU住院时间,左心室射血分数、每搏输出量和药物不良反应发生率.结果 治疗后,试验组和对照组的临床获益率分别为81.82%(18例/22例)和55.00%(11例/20例),差异无统计学意义(P>0.05).治疗后,试验组和对照组的血管活性药物使用时间分别为(54.38±6.47),(64.79±5.80)h;机械通气时间指标分别为(63.17±5.84),(74.57±6.96)h;ICU住院时间指标分别为(7.32±2.84),(9.41±1.92)d,左心室射血分数分别为(39.19±3.04)%和(36.23±3.57)%,每搏输出量分别为(90.82±12.19),(61.33±9.05) mL,差异均有统计学意义(均P <0.05).试验组的药物不良反应主要有低血压及低血钾,对照组的药物不良反应主要有心律失常.试验组和对照组的药物不良反应发生率分别为18.18%(4例/22例)和20.00%(4例/20例),差异无统计学意义(P>0.05).结论 左西孟旦注射液对结核性心包炎患者心包剥脱术后的临床疗效显著,安全性高.%Objective To observe the clinical efficacy and safety profile of levosimendan injection in the treatment of patients with tuberculous pericarditis who underwent pericardial strip.Methods A total of 42 patients with tuberculous pericarditis who underwent pericardial strip were randomly divided into control group (n =20 cases)and treatment group (n =22 cases).The control group received intravenous pump of dobutamine at a dose of 2 μg · kg-1 · min-1 during the first hour,and subsequently increased to 4 μg · kg-1 · min-1 and treated for 23 h.The treatment group received intravenous pump infusion of levosimendan at a loading dose of 12 μg · kg-1 for 10 min,and then treated with levosimendan at the dose of 0.1 μg · kg-1 · min-1 for 1 h,and finally received levosimendan at the dose of 0.1-0.2 μg · kg-1 · min-1 for 23 h.Both groups received the treatments once.The clinical benifit rate,duration of the vasoactive drug use,mechanical ventilation time and intensive care unit (ICU) stays,the stroke volume (SV) and left ventricular ejection fraction (LVEF) as well as the incidences of adverse drug reactions were compared.Results After treatment,the clinical benifit rates of treatment group and the control group were 81.82% (18 cases/22 cases)and 55.00% (11 cases/20 cases),respectively,without significant difference (P > 0.05).After treatment,there were significant differences between the treatment group and the control group in the duration of vasoactive drug use [(54.38 ± 6.47) h vs (64.79 ± 5.80)h],the mechanical ventilation time [(63.17 ± 5.84) h vs (74.57 ± 6.96) h],the duration of ICU stays index [(7.32±2.84)d vs (9.41 ±1.92)d],LVEF [(39.19 ± 3.04)% vs (36.23 ±3.57)%] andSV [(90.82 ±12.19)mL vs (61.33 ± 9.05)mL] (P <0.05).The adverse drug reactions in the treatment group were low blood pressure and low blood potassium;the adverse drug reaction in the control group was rapid arrhythmia.The incidences of the adverse drug reactions in treatment group and control group were 18% (4 cases/22 cases) and 20% (4 cases/20 cases),and no statistically significant difference was shown (P > 0.05).Conclusion Levosimendan injection was effective and safe for treating tuberculous pericarditis patients who underwent pericardial stripping.