垂体后叶素在治疗血管扩张性休克中的应用

目的：探讨小剂量垂体后叶素治疗难治性休克的血流动力学的影响。方法：2008年至2010年大同市第五人民医院ICU病房收治血管扩张性休克患者13例,其中男性9例,女性4例,在常规治疗的基础上使用小剂量垂体后叶素（开始剂量0.04 U/min）,观察0 h（t1）、1 h（t2）、12 h（t3）、24 h（t4）、48 h（t5）后心率、平均动脉压、平均肺动脉压、心脏指数、休克指数、尿量及儿茶酚胺用量的变化。结果：与t1相比,t2～t5平均动脉压均有所升高（P〈0.05）,t3～t5尿量有所升高（P〈0.05）,t2～t5心率下降（P〈0.05）,休克指数下降（P〈0.05）,平均肺动脉压、心脏指数无明显变化,t3～t5去甲肾上腺素用量不同程度下降（P〈0.05）。结论：小剂量垂体后叶素可改善血管扩张性休克病人的血流动力学并减少儿茶酚胺的用量。

Application of Pituitrin in the Treatment of Patients with Vasodilatory Shock

Objective:To investigate the effects of low-dose infusion pituitrian on maintaining hemodynamic stability in patients with refractory shock.Methods:13 patients(9 males,4 females)with vasodilatory shock in ICU department of The Fifth People’s Hospital of Datong City were studied.On the basis of regular therapies,low-dose pituitrin(initial dosage:0.04U/min) were infused.Hemodynamic parameters,including heart rates,mean arterial pressure(MAP),mean pulmonary artery pressure(MPAP),cardiac index(CI),shock index,urine volume and catecholamine requirements were assessed at 0(t1),1(t2),12(t3),24(t4) and 48 hours(t5).Results: Compared with t1,t2～t5 MAP significantly increased(P<0.05);t3～t5 urine volume significantly increased(P<0.05);t2～t5 heart rates and shock index significantly decreased(P<0.05);MPAP、CI had no significantly change;t3～t5 norepinephrine requirements decreased significantly(P<0.05).Conclusion:In patients with vasodilatory shock,continuous low-dose infusion of pituitrin can improve hemodynamics and reduce catecholamine requirements.