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血管活性药物在危重急症的应用 PowerPoint PPT Presentation


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血管活性药物在危重急症的应用. 第一节 概述 危重病救治除应根据不同病因和不同阶段采取相应措施外,急需应用血管活性药物,以改善心血管机能和全身微循环,维持稳定的血流动力学,从而保证重要脏器系统的血液灌注。随着临床危重病监测技术的不断发展,特别是血流动力学监测技术的不断完善和深入,血管活性药物日益广泛而安全地应用于临床危重病救治。. 传统意义上血管活性药物分为血管收缩剂和血管扩张剂两大类,分别用于升降血压为主,随着药物细胞学机制研究的不断深入和危重病临床实践经验的积累,对血管活性药应用范围和价值的认识也在不断加深。. 血管活性药物对心脏和血管系统的影响主要在三个方面:

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血管活性药物在危重急症的应用

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ICUAR


ARa-ARa1-a2-AR

-AR1-2-ARDA1DA2


1-AR1-AR2-AR2-AR


a--ARDA1DA2


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12-5ug/kg.min1-


25-15ug/kg.min1-2-SVCIHRSVR


3>20ug/kg.mina1-(SVR)a->25ug/kg.min


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1/


2000


215ug/kg.min

3


4


5-10ug/kg.min


1CI2PAOPCI34


AdrenalineEpinephrinea---ARa-AR


10.03-0.06ug/kg.min20.06-0.09ug/kg.min3a-1-


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1a-AR2005


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30.5-1mg40.5-1mg5



Noradrenalinea-SVR1-AR2-AR



1SVR10-20ug/kg.min+10-15ug/kg.min+0.05-1ug/kg.min23


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MetaraminatAraminea-


10-100mg5-10%GSNS



(isoprenaline)-AR1-ARSVHRCI2-AR


12-0.02ug/kg.min 1ug/kg.min


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1-AR


DobutamineD-L-b1-SVR2-a1-


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Thanks for you attention


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