Effects of Norepinephrine Combined with Dobutamine on Hemodynamics, Blood Lactic Acid, CCr, FEH2O and FENa of Patients with Septic Shock / 现代生物医学进展

ABSTRACT

Objective:To explore the effects of norepinephrine combined with dobutamine on the hemodynamics,blood lactic acid,creatinine clearance rate (CCr),fractional excretion ofH2O (FEH2O) and fractional excretion of sodium (FENa) of patients with septic shock.Methods:120 cases of patients with septic shock from January 2016 to December 2016 were selected as the research objectives and randomly divided into two groups with 60 cases in each group.Dobutamine was given to both groups,then norepinephrine was additionally given to the observation group,dopamine was additionally given to the control group.The clinical effect,changes of hemodynamics,blood lactic acid,CCr,FEH2O and FENa levels before and after treatment were compared between two groups.Results:The blood lactic acid and FENa levels of both groups were gradually decreased at 6,12,24 and 48 hours after treatment and were significantly lower than those before treatment;the CCr and FEH2O levels were gradually increased and significantly higher than those before treatment (P＜0.01).The blood lactic acid and FENa levels were gradually decreased at 6,12,24 and 48 hours after treatment and were significantly lower than those of the control group at same time (P＜0.01),the FEH2O level was significantly higher than that of the control group at the same time (P＜0.01).The MAP,SVRI of both groups at 6,12,24 and 48 hours after treatment were significantly higher than those before treatment,but the CI at 24,48 hours after treatment were significantly higher than those before treatment (P＜0.01),the MAP of observation group at 6,12,24 and 48 hours after treatment were significantly lower than those before treatment (P＜0.01),the MAP at 6,12 hours after treatment were significantly higher than those before treatment (P＜0.01),the HR of observation group at 6,12,24 and 48 hours after treatment were significantly lower than those of the control group,but SVRI was significantly higher than those of the control group (P＜0.01).The mortality of observation group was 18.33％ at 28th days after treatment,which was 35.00％ in the control group and significantly higher than that of the observation group (P＜0.05).Conclusion:Norepinephrine combined with dobutamine could improve the hemodynamics,reduce the blood lactate level,improve the renal perfusion and prognosis of patients with septic shock.