文章摘要
高 鹏,吴 喆,杨 波,刘 利,张学军.酚妥拉明、多巴胺联合心肺复苏对心搏骤停患者的影响[J].,2017,17(23):4556-4559
酚妥拉明、多巴胺联合心肺复苏对心搏骤停患者的影响
Effects of Phentolamine and Dopamine Combined with Cardiopulmonary Resuscitation on Sudden Cardiac Arrest
投稿时间:2017-03-24  修订日期:2017-04-18
DOI:10.13241/j.cnki.pmb.2017.23.037
中文关键词: 酚妥拉明  多巴胺  心搏骤停  心肺复苏
英文关键词: Phentolamine  Dopamine  Cardiac arrest  Cardiopulmonary resuscitation
基金项目:陕西省自然科学基金项目(2012J0163)
作者单位
高 鹏 西安高新医院 急诊科 陕西 西安 710075 
吴 喆 西安高新医院 急诊科 陕西 西安 710075 
杨 波 西安高新医院 急诊科 陕西 西安 710075 
刘 利 西安交通大学第一附属医院 急诊科 陕西 西安 710061 
张学军 陕西省人民医院 心内科 陕西 西安 710068 
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中文摘要:
      摘要 目的:研究酚妥拉明、多巴胺联合心肺复苏对心搏骤停患者的影响。方法:选择2015年2月至2016年4月在我院进行治疗的心搏骤停患者60名,按照治疗方法的不同分为观察组和对照组,对照组使用常规方法治疗,观察组在对照组基础上联合酚妥拉明及多巴胺治疗。观察和比较两组治疗后的临床疗效、生存情况、血清cTnI、CK、CK-MB、MDA、SOD水平和血流动力学参数的变化。结果:治疗后,观察组总病死率20%,明显低于对照组33.33%(P<0.05)。观察组心肺复苏后0.5-1h血清cTnI水平显著高于对照组(P<0.05),2-24 h血清cTnI水平显著低于对照组(P<0.05);观察组心肺复苏后各时点血清CK、CK-MB水平均显著低于对照组(P<0.05);观察组复苏后24 h的MDA、SOD浓度较对照组[(1.86±1.65) μg/L vs(3.81±1.24) μg/L、(6.58±0.95)μg/L vs(3.74±0.56) μg/L] (P<0.05)。心肺复苏后,观察组患者从第2 h开始MAP值明显高于对照组水平(P<0.05);观察组患者CO值及CI值从第6h开始明显升高显著高于对照组水平(P<0.05);且观察组患者PCWP值各时段均显著低于对照组(P<0.05)。结论:酚妥拉明联合多巴胺用于治疗心搏骤停患者可明显减轻患者心肌损伤,改善其血流动力学及患者预后,提高生存率,且安全性高。
英文摘要:
      ABSTRACT Objective: To study the effects of phentolamine and dopamine combined with cardiopulmonary resuscitation on the patients with cardiac arrest. Methods: 60 patients with cardiac arrest who were treated from February 2015 to April 2016 in our hospital were selected and divided into the control group and the observation group according to different treatment methods. The control group was treated with routine treatment. while the observation group was treated with phentolamine and dopamine based on the control group. The changes of cTnI, CK, CK-MB levels, MDA, SOD concentration and hemodynamics were observed before and after treatment. Results: After treatment, the total mortality was 20% in the observation group, which was significantly lower than that of the control group (33.33%, P<0.05). The levels of cTnI in the observation group were significantly lower than those of the control group at 2 h and 24 h af- ter the cardiopulmonary resuscitation(P<0.05). After the cardiopulmonary resuscitation, the serum levels of CK and CK-MB in the obser- vation group were significantly lower than those in the control group (P<0.05). The concentration of MDA and SOD in the observation group were significantly higher compared with the control group [(1.86±1.65) μg/L vs(3.81±1.24) μg/L、(6.58±0.95)μg/L vs(3.74±0.56) μg/L](P<0.05). After the cardiopulmonary resuscitation, the MAP value of observation group was significantly higher than that of the control group (P<0.05). The CO value and CI value of observation group were significantly increased from the 6th day to the control group (P<0.05), and the PCWP values of observation group were significantly lower than those of the control group (P<0.05). Conclusion: Phentolamine combined with dopamine could effectively improve the cardiac hemodynamics and prognosis of patients with cardiac ar- rest, reduce the myocardial injury and enhance the survival with high safety.
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