特利加压素在感染性休克中的临床应用价值

The clinical efficacy of Terlipressin for treatment of septic shock

目的:探讨特利加压素在感染性休克中的临床应用价值。方法:2011-03-2013-04期间我院综合ICU共收治168例感染性休克患者,对其中56例难治性感染性休克(即产生去甲肾上腺素抵抗)采取加用小剂量特利加压素静脉持续泵入,并观察用药后2、6、12、24h患者的平均动脉压(MAP)、心率(HR)、休克指数、尿量、血乳酸、APACHEⅡ评分及去甲肾上腺素用量的变化。结果:加用特利加压素6h后,平均动脉压明显上升,休克指数明显下降,心率和尿量显著改善,去甲肾上腺素的用量明显降低,与治疗前比较,差异均有统计学意义(P<0.05);用药24h后血乳酸和APACHEⅡ评分有所下降,但差异无统计学意义。结论:对于感染性休克的患者,小剂量持续泵入特利加压素可有效改善其血流动力学,降低去甲肾上腺素的用量,具有一定的临床应用价值。

Objective：To evaluate the clinical efficacy of Terlipressin for treatment of intractable septic shock. Method：From March 2011 to April 2013,the intensive care unit（ICU）of Hubei ZhongShan Hospital,receive and cure to 168 cases of septic shock patients,of which 25 cases with resisting norepinephrine were treated to low dose Terlipressin,with continuous pump intravenous infusion.MAP、HR、shock index、urine volume、the concentration of blood lactate、chronic health evaluation II（APACHE II）scores and norepinephrine doses were recorded and compared before and 2、6、12、24h after the therapy.Result：6h after the administer of Terlipressin,patients’ MAP lose and shock index reduced dramatically.Patients’ HR and urine volume improved significantly;patients’ norepinephrine requirements were reduced obviously（P＆lt;0.05）.After the administration of Terlipressin for 24h,the concentration of blood lactate and APACHE II scores were reduced.Conclusion：For the patients with septic shock, low dose of Terlipressin continuous infusion can effectively improve the blood flow in patients with septic shock dynamics,reducing the use of norepinephrine dose,which can be used as an effective vasopressin,used for the treatment of septic shock.