参麦注射液对老年脓毒症休克患者血流动力学的影响

摘要

Objective To monitor the effect of shenmai injection on hemodynamics of senile septic shock patients using PiCCO technique. Methods 54 cases of septic shock with the syndrome differentiation of Qi and Yin deficiency were randomly divided into 28 cases of shenmai group and 26 cases of control group.The control group received "the sepsis bundle therapy" and the treatment group received the bundle plus shenmai injection(50mL intravenous infusion,2 times a day,for 14 days).Cardiac index(CI),intrathoracic blood volume index(ITBVI),global end-diastolic volume index(GEDVI),extravascular lung water index(EVLWI)and systemic vascular resistance index(SVRI),heart rate(HR),mean arterial pressure(MAP),central venous pressure(CVP),and the dosage of norepinephrine were observed before treatment and treatment of 6h,12h, 24h,48h and 72h. Results Two groups of elderly patients with septic shock on admission in age,sex,APACHE Ⅱscore and HR,CI,MAP, EVLWI and SVRI index differences had no statistical significance(P>0.05). After the bundle therapy,HR decreased,MAP,CI,GEDVI and ITBVI increased,and EVLWI decreased. Compared with the control group,HR decreased significantly in T3 and T4.CI increased significantly in T4 and T5.GEDVI and ITBVI were significantly increased at T1.EVLWI significantly decreased in T5.And SVR I decreases in T2. The doses of norepinephrine were significantly decreased during T3,T4 and T5 time,and the differences were all statistically significant(P0.05).经集束化治疗后显示HR减慢,MAP、CI、GEDVI和ITBVI均有增加,EVLWI有所下降.与对照组比较,参麦组HR在T3和T4时间明显减慢;CI在T4和T5时间显著增加;GEDVI和ITBVI在T1时间明显增高;EVLWI在治疗T5时间明显下降;而SVRI则在T2时间降低;去甲肾上腺素的使用剂量在使用T3、T4和T5时间显著降低,差异均有统计学意义(P<0.05).结论 参麦注射液可改善老年脓毒症性休克患者的血流动力学变化,减少血管活性药物的使用.