多巴酚丁胺在脓毒症休克患者的应用效果分析

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Abstract Objective To explore the influence of dobutamine on blood lactic acid, cardiorenal function and tissue perfusion in patients with septic shock. Methods Patients with septic shock were retrospectively analyzed in our hospital from December 2020 to December 2023. Both groups were given conventional treatment, and were divided into a conventional group and a DOB group according to different treatment plans. The conventional group received norepinephrine treatment, while the DOB group received a combination of dobutamine treatment on this basis. After propensity matching to exclude confounding factors, 51 patients with no significant differences in baseline data were obtained in each group. The changes of heart rate (HR), blood pressure (BP), mean arterial pressure (MAP) and blood lactic acid (LAC) before treatment and on the 1^st day, 3^rd day and 7^th day of treatment, changes of cardiac function [left ventricular ejection fraction (LVEF), cardiac index (CI), global end-diastolic volume index (GEDVI) ], renal perfusion [urine volume (UV), serum creatinine (Scr) ] and renal filtration function [filtered water excretion fraction (FEH₂O), filtered sodium excretion fraction (FENa) ] before treatment and on the 7^th day of treatment and mortality within 28 days were compared between groups. Results There were significant differences in HR, BP, MAP and LAC from the aspects of between groups. On the 1^st day, 3^rd day and 7^th day of treatment, HR and LAC in DOB group were significantly lower than those in conventional group, and BP and MAP were significantly higher than those in conventional group. After 7 days of treatment, LVEF, CI and GEDVI in the two groups were increased significantly, and the DOB group had significantly higher LVEF, CI and GEDVI. UV in both groups after 7 days of treatment was risen significantly while Scr was declined significantly, and UV in DOB group was significantly higher while Scr was significantly lower compared to conventional group. After 7 days of treatment, FEH₂O in both groups was significantly enhanced while FENa was significantly reduced, and FEH2O in DOB group was significantly higher than that in conventional groupwhile FENa was significantly lower. The number of dead cases within 28 days and average survival time were 11 cases (21.57%) and (24.96±6.37) d in conventional group and those in DOB group were 13.73% and (27.04±3.02) d. There was no significant difference in prognosis between the two groups. Conclusion Dobutamine can effectively improve cardiac function and renal function and enhance tissue perfusion in patients with septic shock.

Key words： dobutamine norepinephrine sepsis shock renal perfusion

Received: 12 March 2024

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R631+.4

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	HOU Lin
	WU Xue
	SUN Ziguo

Cite this article:

HOU Lin,WU Xue,SUN Ziguo. Analysis of the application effect of dobutamine in septic shock patients[J]. HuNan ShiFan DaXue XueBao(YiXueBan), 2024, 21(3): 86-90.

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http://yxb.hunnu.edu.cn/EN/ OR http://yxb.hunnu.edu.cn/EN/Y2024/V21/I3/86

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