参附注射液对严重脓毒症患者血流动力学干预作用的临床研究

摘要

Objective:To observe the effect of Shenfu Injection on hemodynamics in severe sepsis.Methods:60 cases with severe sepsis were selected and divided into control group and Shenfu Injection treatment group randomly,two patients were treated by anti-infection,fluid resuscitation,correct acidosis,symptomatic treatment,Shenfu treatment group was given 100 mL Shenfu Injection rapid intravenous infusion,and then to 4 mL/h 24 hour duration pump on the basis of the control group.Hemodynamics of all patients were monitored with radial artery and pulmonary artery catheter,heart rate (HR),mean arterial pressure (MAP),cardiac index (CI),systemic vascular resistance (SVR),systemic vascular resistance index (SVRI) were determined of the two groups were observed and compared before and after treatment for 6,12,24 hours.Results:SVR,SVRI of the two groups patients at each time point (6,12,24 h) were improved at different degree,the effects of Shenfu Injection treatment group were more significant than those of control group (P ＜ 0.05),which returned to normal within 24 hours.Conclusion:Shenfu Injection ins helpful for correcting the hemodynamic disorder of high and low resistance in patients with severe sepsis,and the curative effect is remarkable.%目的:观察参附注射液对严重脓毒症患者血流动力学的影响方法:选择严重脓毒症患者60例,随机分为对照组和参附注射液治疗组,两组病人常规给予抗感染、液体复苏、纠正酸中毒等对症支持治疗,参附治疗组在对照组的基础上先给予100 mL参附注射液快速静滴,然后再以4 mL/h持续24h泵入.所有病人经桡动脉及肺动脉漂浮导管监测血流动力学变化,比较两组病人用药前、用药后6、12、24h各时间点心率(HR)、平均动脉压(MAP)、心脏指数(CI)、体循环阻力(SVR)、体循环阻力指数(SVRI).结果:两组患者治疗6、12、24h各时间点的SVR、SVRI均有不同程度改善,而参附注射液治疗组改善更明显,并于24h内基本恢复正常,与对照组有显著性差异(P＜0.05).结论:参附注射液联合常规治疗严重脓毒症可以更快纠正严重脓毒症患者的“高排低阻型”血流动力学紊乱,疗效显著.