本文關(guān)鍵詞： 重型顱腦損傷 心功能不全 左西孟旦　出處：《山東醫(yī)藥》2017年21期 　論文類型：期刊論文

【摘要】：目的觀察左西孟旦治療重型顱腦損傷合并心功能不全的臨床效果。方法將60例重型顱腦損傷患者隨機(jī)分為觀察組及對(duì)照組各30例。對(duì)照組給予常規(guī)支持治療,觀察組在常規(guī)支持治療的基礎(chǔ)上給予左西孟旦12.5 mg加葡萄糖注射液50 m L靜脈泵入。兩組均治療48 h。分別于治療前及治療48 h,對(duì)比兩組左心射血分?jǐn)?shù)(LVEF)、心指數(shù)(CI)、中心靜脈壓(CVP)及液體出入量差值、肺超聲B線評(píng)分、血漿腦利鈉肽(BNP)及血乳酸水平;統(tǒng)計(jì)兩組機(jī)械通氣時(shí)間、肺部感染發(fā)生率、治療2周格拉斯哥昏迷評(píng)分(GCS)及28 d病死率。結(jié)果治療48 h時(shí),兩組LVEF、CI、肺超聲B線評(píng)分、CVP水平、液體正平衡、血漿BNP、血乳酸水平比較,P均0.05;兩組除28 d病死率外,機(jī)械通氣時(shí)間、肺部感染發(fā)生率、治療2周GSC評(píng)分比較P均0.05。結(jié)論左西孟旦可改善重型顱腦損傷合并心功能不全患者的心功能及血流動(dòng)力學(xué),減少機(jī)械通氣時(shí)間,降低肺部感染發(fā)生率。
[Abstract]:Objective to observe the clinical effect of levosimendan in the treatment of severe craniocerebral injury complicated with cardiac insufficiency. Methods 60 patients with severe craniocerebral injury were randomly divided into observation group (n = 30) and control group (n = 30). . On the basis of routine supportive therapy, the observation group was given levosimendan 12.5 mg plus glucose injection 50 mL intravenous infusion. Both groups were treated for 48 h, before treatment and 48 h after treatment respectively. The left ventricular ejection fraction (LVEFV), cardiac index (CI), central venous pressure (CVP), fluid volume difference, B-line score of pulmonary ultrasound, plasma brain natriuretic peptide (BNPP) and serum lactate level were compared between the two groups. The time of mechanical ventilation, the incidence of pulmonary infection, the Glasgow coma score (GCSs) and the fatality rate of 28 days were calculated. The levels of CVP, positive liquid balance, plasma BNPs and blood lactic acid levels were all 0.05 in B line score of pulmonary ultrasound. In addition to the fatality rate of 28 days, the duration of mechanical ventilation and the incidence of pulmonary infection were observed in the two groups. Conclusion Levosimendan can improve the cardiac function and hemodynamics of patients with severe craniocerebral injury and cardiac insufficiency, and reduce the time of mechanical ventilation. Reduce the incidence of pulmonary infection.
【作者單位】： 河北醫(yī)科大學(xué)第三醫(yī)院;
【基金】：河北省醫(yī)學(xué)科學(xué)研究重點(diǎn)課題(20160586)
【分類號(hào)】：R651.15
【正文快照】： 重型顱腦損傷后通過(guò)腦心反射等神經(jīng)體液因素導(dǎo)致一系列的心血管功能異常[1],造成心肌缺血、壞死,心律失常,心率變異性下降等[2],嚴(yán)重時(shí)可導(dǎo)致心功能不全及心源性休克[3]。國(guó)內(nèi)有研究統(tǒng)計(jì)在重型顱腦損傷患者中出現(xiàn)左心射血分?jǐn)?shù)(LVEF)下降的比例為38%[4]。血流動(dòng)力學(xué)的不穩(wěn)定,又

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本文編號(hào)：1451998