低剂量垂体后叶素治疗儿童感染性休克24例报告  

Treatment of septic shock in children with low dose pituitrin： report of 24 cases

作　　者：杨子江[1] 李敬风[1] 付利民[1] 雷尚兵[1] 刘俊华[1] 吴勇[1] 胡艳萍[1] 

机构地区：[1]湖北省医药学院附属太和医院儿童医疗中心,十堰442000

出　　处：《中华儿科杂志》2011年第11期858-861,共4页Chinese Journal of Pediatrics

摘　　要：目的探讨低剂量垂体后叶素对儿童感染性休克的临床疗效。方法选取2008年1月-2010年12月，我院儿科48例按常规策略治疗满6h休克未纠正的感染性休克患儿并随机（完全随机设计）分成两组（对照组24例、治疗组24例）。对照组继续常规策略给予抗感染、容量复苏、纠酸、糖皮质激素及脏器（呼吸、心脏）支持等治疗，并用多巴胺1～15μg/（kg·min）、去甲肾上腺素0．5～2μg/（kg·min）持续静脉泵人，治疗组6h后加用低剂量垂体后叶素（0．01～0．03U／min）持续静脉泵入，观察两组纠正休克的疗效。结果统计资料显示总有效率（显效＋有效）治疗组为76．2％，对照组为40．0％；死亡率治疗组为33．3％，对照组为60％，差异有统计学意义（P=0．025）。结论儿童感染性休克按常规策略治疗6h未能纠正时加用低剂量垂体后叶素能显著提高纠正休克的效率，缩短治疗时间，降低死亡率。Objective To explore the clinical effect of low dose pituitrin in children with septic shock. Methods A total of 48 pediatric cases with septic shock, in whom 6 hours,conventional treatment could not reverse shock from January 2008 to December 2010, were selected for this study. The patients were divided into two groups randomly （completely random design） （control group 24, remedial group 24 ）. The conventional treatment included antibiotics/fluid resuscitation/correcting acid-base imbalance, glucocortieoid, organ（heart/lung） support, dopamine 1-15 μg/（ kg .min） and norepinephrine 0. 5-2 μg/ （ kg . min） pumped in continuously in the control group. In initial 6 hours the same treatment was given to the remedial group, while low dose pituitrin （0. 01-0. 03 U/min） was pumped additionally during the rest of time. The therapeutic effect on correcting shock was evaluated in both groups. Results The total effective rate was 76. 2% in the remedial group and 40. 0% in the control group; the mortality was 33.3% and 60% respectively. The difference between both groups was significant （ P = 0. 025 ） . Conclusion Low dose pituitrin could improve the clinical effect significantly in children with septic shock in whom 6 hours conventional treatment failed to correct shock, shorten the total periods of treatment, and decrease mortality.

关 键 词：休克 脓毒性 垂体激素类 后叶 血管升压素类 儿童 

分 类 号：R459.7[医药卫生—急诊医学]