论文部分内容阅读
目的:研究多巴胺对急性重症胰腺炎合并感染性休克患者肾脏功能的影响.方法:选择1998年以来在我院接受治疗的急性重症胰腺炎合并感染性休克患者39例,按照患者多巴胺最大泵注速率的不同分为A组14例,B组14例,C组11例,3组患者多巴胺最大泵注速率依次为2~9μg/(kg·min),10~15μg/(kg·min),>15μg/(kg·min).测定、记录所有患者MAP,HR,尿量,BUN,CRE,U-ALB和Uβ2-MG定量及APACHEIII评分.结果:治疗前,3组患者均表现有低血压、心动过速和少尿,多数患者CRE,BUN,U-ALB,Uβ2-MG和APACHEIII评分高于正常值上限.经过抗休克治疗,所有患者的MAP,HR,尿量及BUN,CRE均恢复到正常范围(P<0.01),U-ALB,Uβ2-MG定量及APACHEIII评分也有所恢复(P<0.01),但仍高于正常.结论:在急性重症胰腺炎合并感染性休克的治疗中,应以恢复脏器血流灌注为首要目标,以容量复苏为主,必要时辅以多巴胺等血管活性药物来维持循环稳定.
Objective: To study the effect of dopamine on renal function in patients with acute severe pancreatitis complicated with septic shock.Methods: Thirty-nine patients with acute severe pancreatitis and septic shock who were treated in our hospital since 1998 were selected according to the maximal rate of dopamine injection Were divided into A group of 14 cases, B group of 14 cases, C group of 11 cases, three groups of patients with dopamine maximum pump rate followed by 2 ~ 9μg / (kg · min), 10 ~ 15μg / (kg · min) MAP, HR, urine volume, BUN, CRE, U-ALB, Uβ2-MG and APACHEIII scores of all patients were measured and recorded.Results: Before treatment, all three groups showed hypotension, Tachycardia and oliguria, the scores of CRE, BUN, U-ALB, Uβ2-MG and APACHEIII in most patients were higher than the upper limit of normal.After anti-shock treatment, MAP, HR, urine volume and BUN and CRE in all patients recovered The normal range (P <0.01), U-ALB, Uβ2-MG and APACHEIII scores also recovered (P <0.01), but still higher than normal.Conclusion: In the treatment of acute severe pancreatitis complicated by septic shock, To restore organ perfusion as the primary goal, mainly to capacity recovery, if necessary, supplemented with vasoactive drugs such as dopamine to maintain circulatory stability.