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目的探讨去甲肾上腺素与多巴胺对感染性休克患者血乳酸、病死率的影响。方法选取2012年1月至2013年12月我院重症监护病房(ICU)收治的80例感染性休克患者病例,采用随机数字表法分为两组。多巴胺组患者给予多巴胺10~16μg/(kg·min),去甲肾上腺素组患者给予去甲肾上腺素0.05~1.50μg/(kg·min)持续静脉注入;比较两组患者的病死率、治疗前后血乳酸水平及24 h乳酸清除率等。结果去甲肾上腺素组患的病死率明显低于多巴胺组(P<0.05);两组患者治疗后血乳酸水平较治疗前明显降低,且去甲肾上腺素组患者治疗后血乳酸水平优于多巴胺组(P<0.05);去甲肾上腺素组患者24 h乳酸清除率明显优于多巴胺组,差异有统计学意义(P<0.05)。结论对感染性休克患者去给予甲肾上腺素进行治疗,可有效清除血乳酸,改善患者预后。
Objective To investigate the effects of norepinephrine and dopamine on blood lactate and mortality in septic shock patients. Methods From January 2012 to December 2013, 80 cases of septic shock patients admitted to intensive care unit (ICU) in our hospital were divided into two groups according to random number table. Patients in the dopamine group received 10-16 μg / (kg · min) of dopamine and norepinephrine 0.05-1.50 μg / (kg · min) in the norepinephrine group. The mortality of the two groups was compared before and after treatment Blood lactate levels and 24 h lactic acid clearance and so on. Results The mortality of norepinephrine group was significantly lower than that of dopamine group (P <0.05). The levels of blood lactate in both groups were significantly lower than those before treatment, and the level of blood lactate in norepinephrine group was better than that of dopamine (P <0.05). The lactic acid clearance rate of patients in norepinephrine group was significantly better than that of dopamine group at 24 h (P <0.05). Conclusion The treatment of noradrenaline in patients with septic shock can effectively clear the blood lactate and improve the prognosis of patients.