仰俯卧位对早产儿肺功能的影响

目的　研究仰俯卧位对早产儿肺功能的影响。方法　本文应用美国 Bicore CP- 1 0 0新生儿肺功能仪分别检测 30例健康早产儿 (胎龄 34 .5± 0 .3周 ;体重 1 90 5± 5 2 g)仰俯卧位时肺功能。结果　俯卧位潮气量 ( 5 .4± 0 .2 ml/kg)明显高于仰卧位 ( 4.7± 0 .2 ml/kg,P<0 .0 1 ) ;俯卧位气道阻力 ( 4.5± 0 .4k Pa/L.sec)明显低于仰卧位 ( 5 .7± 0 .5 k Pa/L.sec,P<0 .0 1 ) ;俯卧位动态肺顺应性 ( 2 5 .4± 1 .2 ml/k Pa· kg)明显高于仰卧位 ( 1 7.9± 0 .8ml/k Pa· kg,P<0 .0 1 )。仰俯卧位时健康早产儿的呼吸频率、每分通气量、时间常数及呼吸功均无显著差异。结论　俯卧位可改善健康早产儿潮气量和动态肺顺应性 ,降低气道阻力 ,提示俯卧位是改善早产儿肺功能的适宜体位     

足月新生儿早期肺功能主要指标变化

测定健康足月新生儿出生早期肺功能主要指标 ,为临床提供正常参考值。方法 :应用Biocore CP- 1 0 0新生儿肺功能仪 ,对 1 2 9例生后一天及 5 0例生后三天的足月新生儿进行肺功能测定。第一天组胎龄 39.2± 1 .1周 ,出生体重 3381± 2 5 8g;第三天组胎龄 38.7± 1 .1周 ,出生体重 34 5 1± 2 85 g。结果表示 :第一天组潮气量 4.6± 1 .4ml/kg,每分通气量 0 .2 1± 0 .0 8L/( mim· kg) ,动态肺顺应性 0 .1 4± 0 .0 6 ml/( k Pa· kg)〔1 .4± 0 .6 ml/( cm H2 O· kg)〕,气道阻力 3.8± 1 .9k Pa/( L· S)〔39.1± 1 9.0 cm H2 O/( L· S)〕,呼吸功 1 8.9± 1 0 .9g· cm/kg;第三天组潮气量 4.8± 1 .4ml/kg,每分通气量 0 .2 3± 0 .0 7L/( min· kg) ,动态肺顺应性 0 .1 5±0 .0 5 ml/( k Pa· kg)〔1 .5± 0 .5 ml/( cm H2 O· kg)〕,气道阻力 3.7± 2 .0 k Pa/( LS)〔38.1± 2 0 .5 cm H2 /( L· S)〕及呼吸功 1 6 .8± 9.6 g* cm/kg。两组肺功能结果均无显著差异 ( P>0 .0 5 )。本文新生儿肺功能结果似可作为新生儿早期肺功能正常参考值     

呼吸衰竭新生儿机械通气时呼吸力学动态监测及临床意义

目的探讨呼吸衰竭新生儿机械通气时呼吸力学特征及临床意义。方法对46例机械通气的呼吸衰竭患儿,进行呼吸力学指标监测及血气分析检查。结果两组患儿呼吸系统动态顺应性随疾病的好转逐渐增加[(0.36±0.20)ml/(cmH2O·kg)vs(55±0.1)ml/(cmH2O·kg),(0.33±0.2)ml/(cmH2O·kg)vs(0.43±0.1)ml/(cmH2O·kg)],两组患儿每分通气量在撤机前均有明显升高[(0.45±0.2)L/minvs(0.65±0.2)L/min,(0.43±0.4)L/minvs(0.60±0.3)L/min],呼吸系统动态顺应性和每分通气量与呼吸衰竭的严重程度及并发症的发生有关,呼吸系统动态顺应性与氧合指数呈显著负相关(r=-0.615),与每分通气量呈显著正相关(r=0.618)。结论呼吸衰竭新生儿机械通气时动态监测呼吸力学,可以判断肺部病变的严重程度和呼吸循环系统的并发症,评估通气策略,掌握撤机时机。     

吸痰对呼吸衰竭时机械通气患儿呼吸力学的影响

目的　 监测呼吸衰竭行气管插管和用呼吸机患儿在痰液雍塞和吸痰后呼吸力学变化及保持呼吸道通畅的措施。方法 　对因呼吸衰竭行机械通气的患儿吸痰前及吸痰后 2 0min时 ,监测呼吸频率 (RR) ,呼出潮气量 (VTEXP) ,气管导管周围漏气率 (Leak % ) ,呼吸系统动态顺应性 (CDYN) ,平均气道阻力 (Rawmean)等呼吸力学参数。 结果 　对 11例患儿进行了 5 2例监测 ,吸痰前、后气道阻力分别为 (116 73± 2 7 12 )cmH2 O/L .s和 (93 38± 2 6 6 4)cmH2 O/L .s,两者比较有显著差异P <0 0 1;吸痰前、后气管导管周围漏气率分别为 (18 12± 4 12 ) % ,(8 71± 3 76 ) % ,两者比较差异有显著性P <0 0 5 ;吸痰后呼出潮气量 (7 31± 2 12 )ml/kg较吸痰前 (5 72± 1 2 )ml/kg明显升高 ,P <0 0 1,吸痰后呼吸频率明显降低。 结论 　痰液雍塞时气道的呼吸力学将发生明显变化 ,及时采取措施、彻底清除痰液 ,保持呼吸道通畅 ,在呼吸衰竭治疗中至关重要。     

仰俯卧位对早产儿肺功能的影响

目的　探讨仰俯卧位对早产儿肺功能的影响。方法　应用美国Ｂｉｃｏｒｅ 公司的ＣＰ１００新生儿肺功能监护仪,分别测定３０ 例健康早产儿［（ 胎龄３４．５±０．３）周,体重（１ ９０５±５２） ｇ］ 仰、俯卧位时肺功能。结果　俯卧位潮气量为（５．４００ ±０．２００）ｍｌｋｇ,明显高于仰卧位时的（４．７００ ±０．２００）ｍｌｋｇ（Ｐ＜ ０．０１）;俯卧位气道阻力为（３３．７５０ ±３．０００） ｍｍＨｇ（Ｌ·ｓ） ,明显低于仰卧位时的（４３．０００ ±４．０００）（Ｌ·ｓ）（ Ｐ＜ ０．０１） ;俯卧位动态肺顺应性为（３．３８０ ±０．１６０） ｍｌ（ｍｍＨｇ·ｋｇ） ,明显高于仰卧位时的（２．３８０±０．１１０） ｍｌ（ｍｍＨｇ·ｋｇ）（ Ｐ＜０．０１） ;仰俯卧位时呼吸频率、每分通气量、时间常数及呼吸功差异均无显著意义。结论　俯卧位可改善早产儿的潮气量和动态肺顺应性,降低气道阻力。提示俯卧位可能是改善早产儿肺功能的适宜体位。     

新生儿机械通气撤机时呼吸力学指标的测定及临床意义

目的探讨新生儿机械通气撤机时呼吸力学指标的范围及临床意义。方法通过Bi-core-CP 100呼吸功能监测仪测定32例新生儿机械通气撤机时在CPAP模式、脱机拔管前及拔管后20min等条件下的呼吸力学指标范围,根据拔管48 h内是否重新插管分为撤机成功组与失败组。结果成功组的呼吸力学范围为:Rawmean(93.7±14.3)cmH2O/(L.s)、Crs(0.65±0.09)ml/(cmH2O.kg)、WOBp(1 589±133.2)g.cm/(min.kg);失败组为:Rawmean(98.6±15.5)cmH2O/(L.s)、Crs(0.57±0.08)ml/(cmH2O.kg)、WOBp(1 782±148.6)g.cm/(min.kg)。Crs与WOBp两组差异有显著性。撤机后拔管前两组平均WOBp为(1 846±179.1)g.cm/(min.kg),Crs为(0.624±0.11)ml/(cmH2O.kg)。脱机成功率为81.25%。结论呼吸力学的检测对新生儿呼吸机的撤离有指导作用,特别是呼吸系统顺应性和呼吸功的检测更具有实质意义。     

俯卧位通气对小儿急性肺损伤的疗效

目的评价俯卧位通气对小儿急性肺损伤(ALI)的临床疗效。方法2006年5月-2007年12月苏州大学附属儿童医院儿科重症监护病房收住的17例ALI患儿,在持续镇静下俯卧位通气4h,机械通气模式为压力控制模式(PCmode),以监测呼出潮气量6～8mL/kg反馈调节控制压力,吸气时间0.6～1.0s,呼吸频率28～42次/min,吸入氧体积分数400～1000mL/L,呼气末正压6～16cmH2O(1cmH2O=0.098kPa)。监测0、1、4h及恢复仰卧位通气4h的呼吸循环指标,并进行比较。采用SPSS13.0软件进行统计学分析。结果在实施俯卧位通气1、4h及恢复仰卧位通气4h,氧合指数[pa(O2)/FiO2]和pa(O2)均较实施俯卧位通气前显著升高(Pa<0.05),俯卧位通气4h和恢复仰卧位通气4h时的尿量也有增加(Pa<0.05)。而心率、平均动脉血压、动脉血二氧化碳分压、呼吸系统动态顺应性、呼吸道阻力、呼吸道峰压等比较差异均无统计学意义。结论俯卧位通气可改善ALI患儿的氧合,增加尿量,恢复仰卧位通气后氧合改善,尿量增加仍持续存在。     

剖宫产儿早期潮气呼吸肺功能的研究

目的：研究剖宫产儿早期潮气呼吸肺功能各项指标的特点。探讨剖宫产对新生儿早期肺功能的影响。方法：研究对象分两组:剖宫产组42例,阴道分娩组33例;采用潮气呼吸法测定两组新生儿1h内潮气呼吸肺功能的各项指标。主要参数:每分通气量(MV),呼吸频率(RR),潮气量(VT/kg),吸气时间(TI),呼气时间(TE),吸呼比(TI/TE),达峰时间(TPEF),达峰时间比(TPEF/TE),达峰容积(VPEF),达峰容积比(VPEF/VE),潮气呼吸呼气峰流速(PTEF),25%,50%,75%潮气量时呼气流速(TEF25%,TEF50%,TEF75%)。同时描绘出流速容量环(TFVcurve)。结果：剖宫产组MV为1.16±0.31L/min,VT/kg4.81±1.05mL/kg较阴道分娩组1.34±0.33L/min,5.55±1.24mL/kg明显缩小(P<0.05)。PTEF为69.40±21.96mL/s,TEF25%为62.17±20.62mL/s较阴道分娩儿59.03±15.23mL/s,51.52±13.83mL/s明显增快(P<0.05)。反映气道阻塞的指标:TPEF/TE和VPEF/VE分别为(66.08±11.51)%和(62.19±8.69)%高于经阴道分娩组(60.36±9.70)%和(55.75±7.28)%(P<0.05)。而RR,TI,TE,TI/TE,TEF50%,TEF75%两组无显著差异(P>0.05)。流速容量环:两组新生儿流速容量环呈较狭长的不规则椭圆型,呼气流速峰值延迟出现,剖宫产组的流速容量环窄于经阴道分娩儿,呼气流速峰值高于阴道分娩组。结论：剖宫产儿1h内潮气呼吸肺功能显示潮气量、每分通气量小于经阴道分娩儿,剖宫产儿较阴道分娩儿在1h内限制性通气功能障碍更明显,大气道的阻塞亦更明显。     

新生儿高频振荡通气时呼出气潮气量与动脉二氧化碳分压的研究

目的 探讨新生儿高频振荡通气(HFOV)时呼出气潮气量与动脉二氧化碳分压(PaCO2)变化的关系.方法 对应用HFOV的重症呼吸衰竭新生儿,监测记录PaCO2、呼出气潮气量(VTe)、呼吸机频率(F)、平均气道压(MAP)、振幅(ΔP)及吸入氧浓度(FiO2)等指标,并进行相关性分析.结果 共46例患儿接受HFOV治疗,平均胎龄(36.37 ± 3.53)周,出生体质量(2.76 ± 7.77)kg.不同PaCO2组( ＜ 35 mmHg、35 ～ 45 mmHg、46 ～ 55 mmHg、＞ 55 mmHg)对应VTe/kg平均值分别为(2.20 ± 0.40)ml/kg、(1.96 ± 0.46)ml/kg、(1.71 ± 0.44)ml/kg、(1.21 ± 0.33)ml/kg,组间比较差异有统计学意义(χ2 ＝ 85.74,P ＜ 0.05),Vte/kg与PaCO2呈负相关(r ＝ -0.59,P ＜ 0.05).当PaCO2于正常范围(35 ～ 45 mmHg),MAP为8 ～ 10 cmH2O、11 ～ 13 cmH2O、14 ～ 16 cmH2O、＞ 16 cmH2O时,对应VTe/kg平均值分别为(1.73 ± 0.33)ml/kg、(1.90 ± 0.39)ml/kg、(2.19 ± 0.54)ml/kg、(2.53 ± 0.53)ml/kg,组间比较差异有统计学意义(χ2 ＝ 18.96,P ＜ 0.05),VTe/kg和MAP呈正相关(r ＝ 0.43,P ＜ 0.05).经多元线性回归分析逐步法建立回归方程:PaCO2 ＝ -13 VTe/kg + 4.32 F + 0.13 FiO2 + 19.68(r ＝ 0.68,r2 ＝ 0.47,P ＜ 0.05).结论 新生儿高频振荡通气时VTe/kg与PaCO2呈负相关,PaCO2正常范围时VTe/kg和MAP呈正相关;高频振荡通气时监测VTe可作为调控PaCO2的参考.     

肺表面活性物质治疗新生儿呼吸窘迫综合征的临床对照研究

目的　探讨肺表面活性物质 (PS)治疗新生儿呼吸窘迫综合征 (NRDS)的有效性及临床价值。方法　采用气管内滴注单剂PS治疗NRDS患儿 2 5例 ,并与同期未用PS治疗的 2 5例NRDS患儿进行前瞻性临床对照研究。结果　治疗组在应用PS后 2～ 3h皮肤颜色转红 ,经皮血氧饱和度逐渐升高。 6h后动脉血氧分压 (PaO2 )、动脉 /肺泡血氧分压比值 (a/APO2 )及呼吸机有效指数 (VEI)分别由 ( 48± 14)mmHg( 1mmHg =0 .133kPa)、0 .14± 0 .0 6及 ( 0 .16± 0 .0 9)ml/ (mmHg·kg)上升到 ( 6 5±2 9)mmHg、0 .2 4± 0 .15及 ( 0 .2 9± 0 .16 )ml/ (mmHg·kg) ;而氧合指数 (OI)、吸入氧浓度 (FiO2 )及平均气道压 (MAP)由 11.6± 5 .7、0 .5 9± 0 .13及 ( 15 .6± 3.1)cmH2 O( 1cmH2 O =0 .0 98kPa)逐渐降低至 6 .3±3 .4、0 .47± 0 .10及 ( 13 .5± 2 .4)cmH2 O。经广义线性模型方差分析 ,主效应、分组因素及时间因素对两组PaO2 、a/APO2 、OI、FiO2 、MAP及VEI的值具有明显影响。而分组与时间因素的交互作用无显著影响。治疗组机械通气及氧疗时间较对照组明显缩短 ,二者差异有显著性。结论　PS能有效地改善NRDS患儿肺顺应性及氧合功能 ,缩短需要机械通气及氧疗时间。     

俯卧位对机械通气新生儿氧合和肺力学的影响

目的 研究俯卧位对机械通气新生儿氧合和肺力学的影响.方法 研究对象为2008年5月至2009年2月上海市儿童医院NICU收治的机械通气治疗的新生儿20例,采取交叉设计的方法随机分为仰卧位-俯卧位组和俯卧位-仰卧位组,每组10例.分别采取仰卧位→俯卧位各3h和俯卧位→仰卧位各3h,共6h,记录并分析患儿呼吸机参数、动脉血...     

Effect of body position on tidal volume and minute ventilation in very low birthweight infants

Background: To progress the clinical treatment of neonates, especially in the management of respiration, we have to be able to measure their pulmonary function appropriately. Various methods have been developed, but little is known about the pulmonary function of very low birthweight infants (VLBWI) because of the difficulty in taking their measurements with existing equipment. We have developed a very low dead space pneumotachograph to measure lung function in VLBWI. Methods and results: We used our pneumotachograph on 30 infants each weighing less than 1500 g at birth. The infants were intubated with endotracheal tubes of 2.5 or 2.0 mm diameter to measure tidal volume and minute ventilation in the prone and supine position. The tidal volume in the supine position was 6.99 ± 0.42 mL/kg and 7.58 ± 0.38 mL/kg in the prone position (mean ± SE). The tidal volume was significantly larger in the prone than the supine position (P < 0.05). However, no significant difference was observed in minute ventilation and respiratory rates. Conclusion: The tidal volume significantly increased in the prone position in VBLWI, confirming the previous observation of larger healthy infants is also applicable to the very low birthweight infants.     

Improved oxygenation and lung compliance with prone positioning of neonates.

Fourteen intubated infants recovering from neonatal respiratory disease had arterial blood gases and lung mechanics measured in the supine position and in two variants of the prone position. Prone positioning resulted in significant increases in mean (+/- SEM) arterial oxygen tension (Pa(o2 70.4 +/- 2.5 to 81.1 +/- 4.4mm Hg), dynamic lung compliance (1.7 +/- 0.24 to 2.55 +/- 0.37 ml/cm H2O),and tidal volume (8.6 +/- 1.0 to 10.5 +/- 1.2 ml) when all prone values were compared to supine values. Prone positioning with the abdomen protruding freely, when compared to all supine values, was associated with significantly increased dynamic lung compliance and tidal volume. Values for prone-abdomen free were not significantly different from values for prone-abdomen restricted. This suggests that there are clinical benefits from prone positioning in neonates recovering from respiratory disease.     

Effects of body position on blood gases and lung mechanics of infants with chronic lung disease during tube feeding

BACKGROUND: The effects of body position and feeding on lung mechanics and blood gases in very low birthweight infants with chronic lung disease (CLD) is not fully elucidated. METHODS: Seven very low birthweight infants who were being mechanically ventilated because of CLD were examined. They were enrolled in this study when their feeding volume exceeded 100 mL/kg per day. Each patient was kept on the same position (either prone or supine) during feeding. Feeding was given by a nasogastric tube for over 1 h every 3 h. Blood gases and lung mechanics were evaluated before, 20 min and 40 min after the initiation of the feeding and at the end of the feeding. RESULTS: The prone position resulted in a significant increase in arterial oxygen saturation during feeding. The tidal volume in the prone position was significantly larger than in the supine position only before feeding. There were no significant differences in minute ventilation between these positions during the study. Pulmonary resistance was not different in either position, but the static compliance and the work of breathing of spontaneous breaths were improved significantly when the infants were in the prone position. In the supine position, work of breathing increased and static compliance decreased significantly with time, while in the prone position, those values did not change significantly. CONCLUSION: The improvement in lung mechanics may partly explain better oxygenation obtained in the prone position. The prone position could decrease energy expenditure for spontaneous breathing and may shorten the period of ventilatory support for very low birthweight infants with CLD.     

压力调节容量控制通气治疗新生儿呼吸衰竭

目的 探讨压力调节容量控制(PRVC)通气治疗新生儿呼吸衰竭的疗效。方法 21例呼吸衰竭新生儿中,有Ⅰ型呼吸衰竭5例,Ⅱ型呼吸衰竭16例。予PRVC通气,初调参数:VT 6～8ml/kg,PEEP 2～6 cmH2O,FiO2 0.6～0.7,RR 50次/min.Ti0.4～0.7 s,压力水平上限25～40 cmH2O。结果平均上机时间36.3(10-120)h。治愈16例,死亡2例,3例放弃治疗,1例改用PCV,治愈率76％。并发气压伤1例,肺炎4例。结论PRVC通气治疗新生儿呼吸衰竭有较好的疗效。可减少气压伤,缩短上机时间,减少镇静剂的应用,但由于我们观察病例数较少,有待进一步研究。     

Positive end-expiratory pressure modulates perfluorochemical evaporation from the lungs

To study the effects of positive end-expiratory pressure (PEEP) level on perfluorochemical (PFC) elimination profiles (E(L)), 6 ml/kg of perflubron were instilled into healthy anesthetized rabbits. The ventilation strategy was to maintain constant minute ventilation (300 ml/kg/min) and mean airway pressure (7-8 cm H(2)O) while randomly changing the PEEP levels from 5 to 0, 1, 3, and 10 cm H(2)O, each for a period of 15 min. The PFC content in the expired gas was measured and the E(L) was calculated. There was a significant reduction in the E(L) when decreasing the PEEP levels from 5 to 0 cm H(2)O, but no differences were seen when the PEEP was increased from 5 to 10 cm H(2)O. The results indicate that PEEP levels influence PFC elimination profiles; therefore, the measurement of the E(L) and PEEP levels should be considered when optimizing supplemental PFCs during partial liquid ventilation.     

The effects of body positioning on sucking behaviour in sick neonates

Some infants show better oxygenation in the prone position compared to the supine position while they are bottle-fed; however, the reason for this phenomenon is not clear. The purpose of this study was to obtain a better understanding of the effects of body position on the oral feeding performance, i.e. the sucking pressure, frequency, efficiency, and ventilation. A total of 14 infants (12 full-term, 2 preterm), who often showed O₂ desaturation (SpO₂ < 90) during oral feeding, were enrolled in the study. The infants were fed either in the supine position or in the prone position throughout feeding. Oxygen saturation was recorded with a pulse oxymeter. The sucking pressure was measured with a 1 mm I.D. silicone tube inserted into the artificial nipple. The ventilation volume during bottle feeding was measured with a pneumotachograph. The prone position resulted in better oxygenation (97.2 ± 0.6% prone, 92.5 ± 0.9% supine, P < 0.05) and larger tidal volume (6.4 ± 0.8 ml/kg prone and 4.9 ± 0.6 ml/kg supine, P < 0.05), although the minute ventilation during bottle-feeding was not different from that in the supine position. In the prone position, the sucking pressure and frequency were higher and the duration of each suck was shorter. Conclusion Sucking in the prone position may to some extent reduce disadvantages of oral feeding on ventilation. Received: 18 January 2000 / Accepted: 9 May 2000     

呼吸机撤离后不同体位对新生儿氧合功能的影响

目的：国内外学者已经对多种疾病状态下新生儿体位进行了研究,但对呼吸机撤机后这一关键时期新生儿应采取何种体位尚无报道,该实验通过撤机后最初6 h新生儿仰、俯卧位与其氧合关系的研究,来评价呼吸机撤离后最初6 h内新生儿仰、俯卧位对其氧合功能的影响。方法：受试者随机分为仰卧位组或俯卧位组。吸氧,确保SPO2在正常范围。监测撤机后6 h内的SPO2,记录撤机后1 h及6 h的FiO2,于撤机后1 h及6 h各测动脉血气一次,记录PaO2、PaCO2,并计算A-aDO2、PaO2/FiO2、RI。结果：于撤机后1 h及6 h,俯卧位组FiO2（1 h俯0.4415±0.1152,仰0.5289±0.0986;6 h 俯0.3414±0.1120,仰0.4750±0.1120）、A-aDO2（1 h俯171.06±86.55,仰253.62±71.56;6 h俯105.85±78.18,仰208.48±86.80）及RI(1 h俯2.16±1.24,仰3.74±1.68;6 h俯1.35±1.11,仰3.65±1.28)均明显低于仰卧位组。PaO2(1 h俯88.70±32.65,仰73.43±17.68;6 h俯84.10±13.95,仰70.20±20.27)及PaO2/FiO2 (1 h俯213.49±88.96,仰141.54±43.25;6 h俯275.23±108.83,仰160.62±63.03) 明显高于仰卧位组,均有统计学差异。结论：俯卧位可以改善撤机后最初6 h内新生儿的氧合功能。     

儿茶酚胺类药物对感染性休克兔胃肠灌注的影响

目的 评价多巴胺、多巴酚丁胺和去甲肾上腺素对感染性休克兔胃黏膜二氧化碳分压与动脉血二氧化碳分压差[P(g-a),CO2]及肠系膜上动脉血流量的影响.方法 静脉注入内毒素复制兔感染性休克模型,达到休克标准后随机分成3组:多巴胺组、多巴酚丁胺组和去甲肾上腺素组,每组各8只.每组均按20 ml/(kg·h)输注生理盐水进行容量复苏,同时分别持续静脉滴注多巴胺5μg/(kg·min)、多巴酚丁胺5 μg/(kg·min)和去甲肾上腺素1μg/(kg·min).连续监测平均动脉压、心率、心脏指数和肠系膜上动脉血流指数,每10分钟测定胃黏膜二氧化碳分压1次,每小时进行动静脉血气分析并测定动脉血乳酸.结果 静脉注射内毒素后,3组平均动脉压、心脏指数及肠系膜血流量指数均明显下降,但P(g-a)CO2明显增加,氧输送能力下降,动脉血乳酸升高.分组干预2 h后,去甲肾上腺素组的平均动脉压为(70±3)mm Hg(1 mm Hg=0.133 kPa),明显高于多巴胺组[(66±4)mm Hg]和多巴酚丁胺组[(65±4)mm Hg],差异有显著性(P＜0.05);去甲肾上腺素组的肠系膜血流量指数[(18.7±2.9)ml/(kg·min)]亦明显高于多巴胺组[(16.2±1.6 ml/(kg·min)]和多巴酚丁胺组[(15.8±1.9)ml/(kg·min)],差异有显著性(P＜0.05);去甲肾上腺素组P(g-a)CO2[(30±6)mm Hg]较多巴酚丁胺组[(23±5)mm Hg]明显降低(P＜0.05).结论 感染性休克兔进行容量复苏时,去甲肾上腺素对胃肠灌注的改善较小剂量多巴胺和多巴酚丁胺更为明显.