左西孟旦治疗重型颅脑损伤合并心功能不全的临床效果

发布时间：2018-01-21 16:33

本文关键词： 重型颅脑损伤心功能不全左西孟旦　出处：《山东医药》2017年21期 　论文类型：期刊论文

【摘要】：目的观察左西孟旦治疗重型颅脑损伤合并心功能不全的临床效果。方法将60例重型颅脑损伤患者随机分为观察组及对照组各30例。对照组给予常规支持治疗,观察组在常规支持治疗的基础上给予左西孟旦12.5 mg加葡萄糖注射液50 m L静脉泵入。两组均治疗48 h。分别于治疗前及治疗48 h,对比两组左心射血分数(LVEF)、心指数(CI)、中心静脉压(CVP)及液体出入量差值、肺超声B线评分、血浆脑利钠肽(BNP)及血乳酸水平;统计两组机械通气时间、肺部感染发生率、治疗2周格拉斯哥昏迷评分(GCS)及28 d病死率。结果治疗48 h时,两组LVEF、CI、肺超声B线评分、CVP水平、液体正平衡、血浆BNP、血乳酸水平比较,P均0.05;两组除28 d病死率外,机械通气时间、肺部感染发生率、治疗2周GSC评分比较P均0.05。结论左西孟旦可改善重型颅脑损伤合并心功能不全患者的心功能及血流动力学,减少机械通气时间,降低肺部感染发生率。
[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.
【作者单位】：河北医科大学第三医院;
【基金】：河北省医学科学研究重点课题(20160586)
【分类号】：R651.15
【正文快照】： 重型颅脑损伤后通过脑心反射等神经体液因素导致一系列的心血管功能异常[1],造成心肌缺血、坏死,心律失常,心率变异性下降等[2],严重时可导致心功能不全及心源性休克[3]。国内有研究统计在重型颅脑损伤患者中出现左心射血分数(LVEF)下降的比例为38%[4]。血流动力学的不稳定,又

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