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目的:探讨酚妥拉明对重症脓毒症患者微循环的改善作用,以及对肾功能的影响。方法:采用数字表法将符合入选标准的重症脓毒症患者51例随机分为研究组和对照组。遵照SSC2012指南,2组给以常规治疗,研究组加用酚妥拉明治疗,观察患者治疗前后甲襞微循环、及肾功能的变化,记录治疗后的APACHEⅡ、ICU的入住天数和30 d的病死率。结果:研究组的甲襞微循环、血尿素氮(BUN)、肌酐(Scr)、尿量、尿乙酰-氨基葡萄糖苷酶(NAG)及γ-谷氨酞转肤酶(γ-GPT)改善优于对照组,差异具有统计学意义(P<0.05或P<0.01)。治疗后2组的ICU的入住天数、血液透析比率和30 d的病死率均有统计学意义(P<0.05或P<0.01)。结论:联合应用酚妥拉明能显著改善脓毒症患者早期微循环和肾脏的血流灌注,提高脓毒症患者的生存率及生存质量。
Objective: To investigate the effect of phentolamine on microcirculation in patients with severe sepsis and its effect on renal function. Methods: Fifty-one patients with severe sepsis who met the inclusion criteria were randomly divided into study group and control group by digital table method. According to the SSC2012 guidelines, the two groups were given routine treatment. The study group was treated with phentolamine. The microcirculation of formazan and renal function before and after treatment was observed. The APACHEⅡ, ICU stay days and 30 days Case fatality rate. Results: The improvement of nailfold microcirculation, BUN, Scr, urine volume, NAG and γ-GPT Better than the control group, the difference was statistically significant (P <0.05 or P <0.01). The ICU stay, hemodialysis rate and 30-day mortality of two groups after treatment were statistically significant (P <0.05 or P <0.01). Conclusion: The combination of phentolamine can significantly improve the early microcirculation and renal perfusion in sepsis patients and improve the survival rate and quality of life of patients with sepsis.