多巴胺与去甲肾上腺素在休克治疗中的应用研究

摘要

Objective:To investigate dopamine and norepinephrine in shock therapy.Method:A total of 200 shock patients were collected.According to the method of treatment, they were divided into dopamine ( DA) group ( n =65) , norepinephrine ( NE) group ( n =65) , dopamine and norepinephrine ( DA+NE) group (n =70).Treatment efficacy, incidence of complications and 28 days mortality were compared be-tween groups.Result: After treatment, serum creatinine levels in three groups were significantly different. Serum creatinine levels in DA group were significantly higher than the NE group and DA +NE group.Other indicators had no statistical difference.Arrhythmia was 30.76%in the DA group, which was significantly higher than 13.85%in the NE group (χ2=5.370, P =0.021) , and DA +NE group was 20.0%.28 days mortality rate in DA group was 24.62%, but in NE group, the mortality rate was 21.54%, and DA +NE group was 18.57%.There was no significant difference the three (χ2=0.725;P =0.394) .Conclusion:In the treatment of shock, norepinephrine has more obvious advantages in terms of stabilizing the heart rate and reducing renal damage compared with dopamine, which is the best drug to treat shock.%目的：探讨多巴胺与去甲肾上腺素在休克治疗中的应用；方法：选择休克患者共200例，按照治疗方法，分为多巴胺组（DA组）（n＝65），去甲肾上腺素组（NE组）（n＝65），多巴胺联合去甲肾上腺素组（ DA＋NE组）（ n＝70），比较治疗效果与并发症的发生率，并比较各组28d的死亡率。结果：治疗后血肌酐水平在三组中有显著差异，DA组血肌酐水平显著高于NE组和DA＋NE组，其他各项无统计学差异。 DA组治疗期间心律失常的发生率为30．76％，显著高于NE组的13．85％（χ2＝5．370，P＝0．021），DA＋NE组为20．0％。 DA组28d死亡率为24．62％，NE组死亡率为21．54％，DA＋NE组为18．57％，三者无统计学差异（χ2＝0．725，P＝0．394）。结论：去甲肾上腺素在休克的治疗中，在稳定心率以及降低对肾功能损伤等方面较多巴胺具有更明显的优势，是目前治疗休克最佳药物。