垂体后叶素雾化吸入治疗难治性咯血的临床观察

目的 观察垂体后叶素雾化吸入治疗难治性咯血的临床疗效和不良反应.方法 将43例难治性咯血患者按随机数字表法分为2组：治疗组23例给予垂体后叶素间断雾化吸入止血治疗,对照组20例给予持续静脉输注止血治疗.比较2组治疗3d、1周时的止血效果及治疗期间不良反应发生情况.治疗组中16例反复阵发性咯血的患者,应用自身对照方法雾化吸入垂体后叶素或生理盐水,观察反复阵发性咯血时垂体后叶素雾化吸入的即时止血效果.结果 治疗组垂体后叶素雾化吸入的即时止血有效率81.3％,高于生理盐水雾化吸入的43.7％ （P＜0.05）.垂体后叶素止血治疗3d时治疗组、对照组止血总有效率分别为52.2％和70.0％,1周时分别为73.9％和90.0％,2组比较差异均无统计学意义（P＞0.05）.治疗组不良反应发生率为21.7％,明显少于对照组的65.0％,2组比较差异有统计学意义（P＜0.01）,治疗组无低钠血症发生.结论 垂体后叶素雾化吸入有一定的即时止血作用.治疗难治性咯血时,与静脉输注比较临床疗效相当,但不良反应发生率明显降低,且未见低钠血症发生.

Aerosol Inhalation of Pituitrin for Refractory Hemoptysis

Objective To observe the clinical efficacy and adverse reactions of aerosol inhalation of pituitrin in the treatment of refractory hemoptysis. Methods Forty-three patients with refractory hemoptysis were randomly assigned to receive either pituitrin aerosol inhalation （treatment group, n=23） or continuous intravenous pituitrin infusion （control group, n=20）. Hemostatic efficacy and adverse reactions were compared between the two groups after treatment for 3 and 7 days. In addition, 16 patients in treatment group were given normal saline for self-control to observe the hemostatic effect of pituitrin aerosol inhalation on recurrent paroxysmal haemoptysis. Results In treatment group, pituitrin aerosol inhalation resulted in a significantly higher effective hemostasis rate than normal saline aerosol inhalation （81.3% vs 43.7%; P〈0.05）. After treatment for 3 and 7 days, the total effective rates were, respectively, 52.2% and 73.9% in treatment group, and 70.0% and 90.0% in control group. There no significant differences between the two groups（P〉0.05）. However, the incidence of adverse reactions in treatment group was significantly lower than that in control group （21.7% vs 65.0% ;P〈0.01）. No patients had hyponatremia in treatment group. Conclusion Aerosol inhalation of pituitrin is effective for refractory hemoptysis and has equivalent clinical efficiency with intravenous infusion of pituitrin. Furthermore, pituitrin aerosol inhalation significantly reduced the incidence of adverse events, especially the hyponatremia.