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目的:采用系统评价对比分析多巴胺与去甲肾上腺素治疗感染性休克的疗效。方法:采用计算机检索的方式,对常用数据库如万方、知网、维普等(2006年1月~2013年13月)有关于多巴胺与去甲肾上腺素治疗感染性休克疗效比较的对照试验(RCT)进行检索,对纳入研究的方法学质量进行评价,并提取有效数据后采用Meat分析。结果:本次研究总计有15个RCT纳入,共有休克患者5782例,经Meat分析可知,采用多巴胺治疗感染性休克相较于采用去甲肾上腺素治疗能明显增加住院期间患者死亡率,对比差异有统计学意义(P<0.01);多巴胺治疗发生心律失常的概率明显比去甲肾上腺素治疗要高近3倍,对比差异有统计学意义(P<0.01);多巴胺治疗后患者心脏指数相较于去甲肾上腺素有显著增加,对比差异有统计学意义(P<0.01);采用多巴胺与去甲肾上腺素治疗感染性休克,在心率与平均脉压上并无显著性差异(P>0.05)。结论:对于感染性休克患者,采用去甲肾上腺素治疗相较于多巴胺治疗更有效与安全,能降低患者住院时死亡率、心律失常事件发生率,值得借鉴。
OBJECTIVE: To systematically evaluate the efficacy of dopamine and norepinephrine in the treatment of septic shock. Methods: A computer-based search of commonly used databases such as Wanfang, Zhidu, Vip et al. (January 2006-March 2013) compared the efficacy of dopamine and norepinephrine in the treatment of septic shock in a controlled trial (RCT ) To evaluate the methodological quality of the included studies, and meat analysis was used after valid data were extracted. RESULTS: A total of 15 RCTs were included in this study, 5782 patients were treated with total shock. According to the analysis of the meat, we found that the treatment of septic shock with dopamine significantly increased the hospital mortality during hospitalization compared with norepinephrine treatment. The difference was (P <0.01). The incidence of arrhythmia in dopamine treatment was nearly 3 times higher than that of norepinephrine treatment (P <0.01), and the cardiac index of patients after dopamine treatment was significantly lower than that of norepinephrine treatment Norepinephrine increased significantly (P <0.01). There was no significant difference in heart rate and mean pulse pressure between treatment with dopamine and norepinephrine (P> 0.05). Conclusion: In patients with septic shock, norepinephrine treatment is more effective and safe than dopamine treatment, which can reduce the incidence of inpatient mortality and arrhythmia and is worth learning from.