外科患者使用的“肾剂量”多巴胺：是教条还是科学？
"Renal dose" dopamine in surgical patients: dogma or science?
作者信息
Perdue P W, Balser J R, Lipsett P A, Breslow M J
机构信息
Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
出版信息
Ann Surg. 1998 Apr;227(4):470-3. doi: 10.1097/00000658-199804000-00003.
OBJECTIVE
"Renal dose" dopamine is widely used in the perioperative period to provide renal protection. A comprehensive review of the literature was performed to determine whether dopamine does in fact confer protection on the kidneys of surgical patients.
SUMMARY BACKGROUND DATA
Studies in healthy animals and human volunteers reveal that dopamine causes diuresis and natriuresis, as well as some degree of renal vasodilatation.
RESULTS
Studies of the perioperative use of dopamine fail to demonstrate any benefit of dopamine in preventing renal failure. Studies in congestive heart failure, critical illness, and sepsis also fail to show any benefit of dopamine other than diuresis. Further, dopamine administration is not completely without risk, because of dopamine's catecholamine and neuroendocrine functions.
CONCLUSIONS
Routine use of prophylactic "renal dose" dopamine in surgical patients is not recommended.
目的
“肾剂量”多巴胺在围手术期被广泛使用以提供肾脏保护。对文献进行全面综述以确定多巴胺是否确实能保护手术患者的肾脏。
总结背景数据
对健康动物和人类志愿者的研究表明，多巴胺可引起利尿和利钠，以及一定程度的肾血管扩张。
结果
围手术期使用多巴胺的研究未能证明多巴胺在预防肾衰竭方面有任何益处。对充血性心力衰竭、危重病和脓毒症的研究也未能表明多巴胺除利尿作用外有任何益处。此外，由于多巴胺的儿茶酚胺和神经内分泌功能，使用多巴胺并非完全没有风险。
结论
不建议在手术患者中常规预防性使用“肾剂量”多巴胺。
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