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目的:观察多巴胺试验诊断危重烧伤患者术中发生过敏性休克的效果。方法:选择危重烧伤手术患者36例,在手术过程中发生>1min严重低血压时,立即单次静脉推注20mg多巴胺,如动脉收缩压回升或超过基础值维持>5min,认为多巴胺试验阴性,按照外科低血容量休克处理;若动脉收缩压仍处于低水平,或上升幅度较小以及回升至下降前水平持续时间<1min,认为多巴胺试验为阳性,按照过敏性休克处理。结果:多巴胺试验诊断烧伤术中过敏性休克的敏感度为92.3%,漏诊率为7.7%,特异性为91.3%,误诊率为8.7%,正确诊断指数为83.6%。结论:多巴胺试验可较准确诊断烧伤术中过敏性休克。
OBJECTIVE: To observe the effect of dopamine test on the diagnosis of anaphylactic shock in patients with critical burn. Methods: Thirty-six patients with severe burn surgery were selected. During the course of operation,> 1 minute serious hypotension occurred. Immediate bolus injection of 20mg dopamine, such as arterial systolic blood pressure recovery or more than 5min, maintained that the dopamine test was negative. Surgical hypovolemic shock treatment; if the arterial systolic blood pressure is still at a low level, or small increase and the level of recovery to decline before the duration of <1min, that dopamine test was positive, according to anaphylactic shock treatment. Results: The sensitivity of dopamine test for diagnosis of anaphylactic shock was 92.3%. The missed diagnosis rate was 7.7%, the specificity was 91.3%, the misdiagnosis rate was 8.7% and the correct diagnosis index was 83.6%. Conclusion: Dopamine can diagnose anaphylactic shock more accurately.