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目的:研究酚妥拉明、多巴胺联合心肺复苏对心搏骤停患者的影响。方法:选择2015年2月至2016年4月在我院进行治疗的心搏骤停患者60名,按照治疗方法的不同分为观察组和对照组,对照组使用常规方法治疗,观察组在对照组基础上联合酚妥拉明及多巴胺治疗。观察和比较两组治疗后的临床疗效、生存情况、血清cTnI、CK、CK-MB、MDA、SOD水平和血流动力学参数的变化。结果:治疗后,观察组总病死率20%,明显低于对照组33.33%(P<0.05)。观察组心肺复苏后0.5-1h血清c Tn I水平显著高于对照组(P<0.05),2-24 h血清cTnI水平显著低于对照组(P<0.05);观察组心肺复苏后各时点血清CK、CK-MB水平均显著低于对照组(P<0.05);观察组复苏后24 h的MDA、SOD浓度较对照组[(1.86±1.65)μg/L vs(3.81±1.24)μg/L、(6.58±0.95)μg/L vs(3.74±0.56)μg/L](P<0.05)。心肺复苏后,观察组患者从第2 h开始MAP值明显高于对照组水平(P<0.05);观察组患者CO值及CI值从第6h开始明显升高显著高于对照组水平(P<0.05);且观察组患者PCWP值各时段均显著低于对照组(P<0.05)。结论:酚妥拉明联合多巴胺用于治疗心搏骤停患者可明显减轻患者心肌损伤,改善其血流动力学及患者预后,提高生存率,且安全性高。
Objective: To study the effect of phentolamine, dopamine and cardiopulmonary resuscitation on patients with cardiac arrest. METHODS: Sixty patients with cardiac arrest who were treated in our hospital from February 2015 to April 2016 were divided into observation group and control group according to the different treatment methods. The control group was treated by conventional method. The observation group was treated in control group Group based on combination of phentolamine and dopamine treatment. The clinical efficacy, survival, serum cTnI, CK, CK-MB, MDA, SOD levels and hemodynamic parameters were observed and compared between the two groups after treatment. Results: After treatment, the total mortality of the observation group was 20%, which was significantly lower than that of the control group (33.33%, P <0.05). The levels of cTnI in the observation group were significantly higher than those in the control group (P <0.05), and the level of cTnI in the serum was significantly lower than that in the control group (P <0.05) The levels of serum CK and CK-MB were significantly lower than those in the control group (P <0.05). The levels of MDA and SOD in the observation group were significantly higher than those in the control group [(1.86 ± 1.65) μg / L vs (3.81 ± 1.24) μg / L, (6.58 ± 0.95) μg / L vs (3.74 ± 0.56) μg / L] (P <0.05). After cardiopulmonary resuscitation, the MAP in observation group was significantly higher than that in control group at 2 h (P <0.05). CO and CI values in observation group increased significantly from 6h (P < 0.05). The PCWP values in the observation group were significantly lower than those in the control group (P <0.05). Conclusion: Phentolamine combined with dopamine in patients with cardiac arrest can significantly reduce myocardial damage, improve hemodynamics and prognosis, improve survival rate, and high safety.