论文部分内容阅读
目的:探讨对感染性休克患者应用β1-受体阻滞剂控制心率对血流动力学以及预后的影响。方法:选取2012-01-2016-10我院重症监护病房收治的80例感染性休克患者为研究对象,随机分为对照组和观察组,每组40例。对照组给予常规抗感染性休克治疗,观察组在此基础上给予静脉注射盐酸艾司洛尔注射液。记录比较2组治疗前(T1)及治疗后24h(T2)、48h(T3)、72h(T4)的各项血流动力学指标、左室射血分数(LVEF)、左室舒张末期直径(LVEDD)及E峰与A峰比值(E/A),并对比2组住院期间的并发症发生率及病死率。结果:观察组心率在用药后明显下降,在24h、48h、72h时均低于对照组(P<0.05);2组MAP、SpO2比较,差异无统计学意义。治疗前2组患者心脏功能指标比较差异无统计学意义;治疗后观察组LVEDD、LVEF与E/A均高于对照组,差异具有统计学意义(P<0.05)。观察组急性肾损伤、急性呼吸窘迫综合症(ARDS)的发生率均低于对照组(P<0.05),此外观察组病死率为52.5%,显著低于对照组的85.0%,差异具有统计学意义(P<0.05)。结论:感染性休克患者使用β1-受体阻滞剂,可有效控制心率,改善心室的顺应性以及舒张功能,提高组织灌注水平,减轻对脏器的损伤,改善患者预后,因此可作为临床治疗感染性休克的有效药物选择之一。
Objective: To investigate the effect of β1-blocker on hemodynamics and prognosis in septic shock patients. Methods: Eighty septic shock patients admitted to intensive care unit of our hospital from January 2012 to October 2016 were selected as control group and observation group, 40 cases in each group. The control group was given conventional anti-septic shock treatment, and the observation group was given intravenous esmolol hydrochloride injection on the basis of this. The hemodynamics, left ventricular ejection fraction (LVEF), left ventricular end-diastolic diameter (LVEF) and left ventricular end diastolic pressure (LVEF) were recorded and compared between the two groups before treatment (T1), 24h (T2), 48h (T3) and 72h LVEDD), and the ratio of E peak to A peak (E / A). The complication rates and mortality rates of two groups were compared. Results: The heart rate of observation group decreased significantly after treatment, and was lower than that of control group at 24h, 48h and 72h (P <0.05). There was no significant difference in MAP and SpO2 between two groups. There was no significant difference in cardiac function between the two groups before treatment. LVEDD, LVEF and E / A in the observation group after treatment were significantly higher than those in the control group (P <0.05). The incidence of acute renal injury and acute respiratory distress syndrome (ARDS) in the observation group was lower than that in the control group (P <0.05). In addition, the case fatality rate in the observation group was 52.5%, which was significantly lower than that in the control group (85.0%). The difference was statistically significant Significance (P <0.05). Conclusion: The use of β1-blockers in patients with septic shock can effectively control heart rate, improve ventricular compliance and diastolic function, improve tissue perfusion, reduce organ damage and improve prognosis, so it can be used as a clinical treatment One of the effective drug options for septic shock.