特利加压素治疗难治性感染性休克患者的临床效果

Clinical effect of terlipressin on treating patients with intractable septic shock

目的探讨特利加压素对难治性感染性休克患者心指数、外周循环阻力的影响。方法选取我院2011年1月-2014年1月收治入院的感染性休克患者作为研究对象,所有患者给予积极体液复苏并使用大剂量去甲肾上腺素治疗,其中88例感染性休克患者循环仍难以维持,临床给于加用特利加压素（125μg/h）,观察患者治疗前后平均动脉压、脉搏、心指数、外周循环阻力指数、尿量、血肌酐、尿素氮等指标。结果患者治疗后6、12、24、48 h MAP、SVRI均明显高于治疗前,而HR、CI等指标治疗后12、24、48 h明显低于治疗前,去甲肾上腺素用量明显低于治疗前,差异有统计学意义（P〈0.05）;治疗后第1、3、7天尿量明显高于治疗前,而血肌酐、尿素氮在治疗后第3、7天时明显低于治疗前,差异均有统计学意义（P〈0.05）。结论特利加压素应用于难治性感染性休克能够改善心指数和外周循环阻力,临床效果显著,可在临床广泛推广。

Objective To explore the influence of terlipressin on cardiac index and peripheral vascular resistance in patients with intractable septic shock. Methods From January 2011 to January 2014,patients with septic shock treated and admitted into our hospital were selected as research objects.All patients were positively provided with fluid resuscitation and high dosage of norepinephrine for treatment.Among them,there were 88 septic shock patients whose circulation was hard to maintain,and 125 μg/h terlipressin was added in clinic.Mean arterial pressure（MAP）,heart rate（HR）,cardiac index（CI）,index of systemic vascular resistance（SVRI）,urine volume,serum creatinine,and urea nitrogen before and after treatment were observed. Results MAP and SVRI 6,12,24,and 48 hours after treatment were much higher than those before treatment,and HR and CI 12,24,and 48 hours after treatment were greatly lower than those before treatment.The dosage of norepinephrine used was obviously lower than that before adding norepinephrine,which all displayed statistical difference（P〈0.05）.1,3,and 7 days after therapy,volume of urine was much more than that before,and serum creatinine,blood urea nitrogen 3 and 7 days after treatment were much lower than those before treatment with statistical difference（P〈0.05）. Conclusion Additional application of terlipressin to treat intractable septic shock can improve CI and SVRI in a remarkable clinical effect,which is worthy of expansive promotion in clinic.