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目的观察去甲肾上腺素和多巴胺在老年脓毒性休克治疗中的应用效果。方法选取医院收治的66例老年脓毒性休克患者,按照治疗方法不同分为去甲肾上腺素组36例和多巴胺组30例。观察2组病死率、血流动力学变化和心律失常发生率。结果 2组治疗后第7、28天病死率比较差异无统计学意义(P>0.05)。2组在给药6 h CVP和MAP比较差异无统计学意义(P>0.05);去甲肾上腺素组给药6 h后HR低于多巴胺组,SVRI和CI均高于多巴胺组,差异有统计学意义(P<0.05),去甲肾上腺素组心律失常发生率低于多巴胺组,差异有统计学意义(P<0.05)。结论对于老年人脓毒性休克患者,去甲肾上腺素和多巴胺均能够维持患者血流动力学的稳定,2种药物疗效相当,但多巴胺更易引发老年患者出现心律失常风险。
Objective To observe the effect of norepinephrine and dopamine in the treatment of senile septic shock. Methods Sixty-six elderly patients with septic shock were selected and divided into norepinephrine group (n = 36) and dopamine group (n = 30) according to the method of treatment. The mortality, hemodynamic changes and incidence of arrhythmia in two groups were observed. Results There was no significant difference in mortality between the two groups on the 7th and 28th days (P> 0.05). There was no significant difference in CVP and MAP between the two groups at 6 h (P> 0.05). After 6 h of norepinephrine treatment, HR was lower than that of dopamine group, SVRI and CI were higher than those of dopamine group (P <0.05). The incidence of arrhythmia in norepinephrine group was lower than that in dopamine group (P <0.05). Conclusions Both norepinephrine and dopamine maintain hemodynamic stability in elderly patients with septic shock. The two drugs are equally effective, but dopamine is more likely to trigger the risk of arrhythmia in elderly patients.