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近25年来循环衰竭的治疗发生了很大的变化,不但出现了一些新的药物,而且对重症病人循环的了解也有了进展。50年代的主要概念是,处理循环衰竭时不惜代价地维持血压,目的是为了保证脑、肾和冠状循环的最高灌注压,因而曾长时间应用血管收缩药。这对正常心脏虽可耐受血管阻力的增加,不致降低心排血量,但对抑制了的心肌就会因后负荷的增加相应地降低搏出量和心排血量,直至发生不可逆休克。如病人患缺血性心脏病,血管收缩药可增加
In the past 25 years, the treatment of circulatory failure has undergone great changes. Not only new drugs have emerged, but also the understanding of circulatory diseases in critically ill patients. The main concept of the 1950s was to maintain blood pressure at any cost in the treatment of circulatory failure in order to ensure the highest perfusion pressure in the brain, kidney and coronary circulation and therefore to have used vasoconstrictor for a long time. Although the normal heart can tolerate increased vascular resistance, will not reduce the amount of cardiac output, but the inhibition of the myocardium will be due to increased post-load stroke volume and cardiac output accordingly, until the occurrence of irreversible shock. If the patient is suffering from ischemic heart disease, vasoconstrictor drugs can increase