垂体后叶素在小儿心肺复苏中的应用研究  

Application of posterior pituitary hormone in pediatric cardiopulmonary resuscitation

作　　者：徐南平 王爱红 郭兰芳 徐芳菲 吴卫萍 

机构地区：[1]南昌市儿童医院急诊中心,江西330006

出　　处：《中国急救复苏与灾害医学杂志》2014年第6期509-515,共7页China Journal of Emergency Resuscitation and Disaster Medicine

基　　金：江西省科技攻关计划资助项目（2006）

摘　　要：目的探讨垂体后叶素在小儿心肺复苏中的近期疗效。方法随机收集急诊科和ICU收治的心跳停搏患者201例，其中肾上腺素标准剂量组（对照组）111例，垂体后叶激素（含血管加压素）联合肾上腺素组（治疗组）90例。根据心跳停搏时间分为三组：心跳停搏1〉30min组、心跳停搏时间不详组和心跳停搏时间≤30min组。心跳停搏≤30min者又分成两组：单独重复使用（≥3次）的标准剂量肾上腺素（0．01mg／kg／次）组（标准对照组）32例，先单独使用标准剂量肾上腺素（0．01mg／kg／次），无效后加用垂体后叶激素为观察治疗组18例。治疗组随机分成甲、乙、丙三组：甲组：垂体后叶激素0．4U／kg／次，静脉注射；若无效每隔5min重复一次，肾上腺素剂量不变；垂体后叶激素剂量依次为0．6U／kg／次、0．8U／kg／次；乙组：垂体后叶激素0．6U／kg／次，若无效每隔5min重复一次，剂量依次为0．8U／kg／次、1U／kg／次；丙组：垂体后叶激素0．8U／kg／次，若无效每隔5min重复一次，剂量依次为1U／kg／次、1．2U／kg／次。各剂量组在注射3次复苏药后进行判断。结果各组病例多在2～3剂后见效并且复苏成功。少数注射3次复苏药后心跳不稳定或者无效，复苏时间〈30min，而不愿放弃者，继续使用复苏药。用第4剂复苏药的19例，其中初步复苏成功2例；用第5剂的仅1例，且无效。治疗组的初步复苏成功率（43．13％）和自主循环恢复率（37．25％）与对照组（45．9％、47．54％）比较差异均无统计学意义，Х^2=0．217、0．85，P〉0．05。虽然治疗组与对照组的疾病构成比略有差异，但治疗组的初步复苏成功率（26．67％）和自主循环恢复率（35．56％）与对照组（28．83％、30．63％）比较差异无统计学意义，Х^2=0．116、0．547，P〉0．05；心跳停搏≤30min对照组初步复苏成功率Objective to investigate the effects of administration of posterior pituitary hormone （vasopressin,VAS） in pediatric cardiopulmonary resuscitation. Methods 201 pediatric patients with cardiopulmonary arrest, 130 male and 71 female, aged （9.13 ±1.29）months, admitted in the emergency department and ICU were randomly collected and divided into 2 groups： epinephrine standard-dose group （control group ）, 111 cases, and treatment group （90 case）. The patients of the control group underwent intravenous injection of epinephrine 0.0 1mg/kg, time and then 0.01 mg/kg every 5 min p.r.n. The cases of the treatment group were randomly divided into 3 groups： Group A undergoing intravenous injection of epinephrine 0.01 mg/kg/time and intravenous injection of posterior pituitary hormone 0.4 U/kg/time and then with the increasing doses of 0.4 U and 0.8 U/kg, combined with epinephrine group; Group B, undergoing intravenous injection of epinephrine and posterior pituitary hormone 0.6 U//kg/time and then with the increasing doses of 0.8 and 1.0 U//kg/time every 5 min p.r.n., and Group C undergoing intravenous injection of epinephrine 0.01 mg/kg/ time and intravenous injection of posterior pituitary hormone 0.8 U/kg/time and then with the increasing doses of 1.0 U and 1.2 U/kg, combined with epinephrine. The control group was given in standard-doses of epinephrine 0.01 mg/kg, intravenously, repeated every 5 minutes. According to cardiac arrest time the cases were divided into 3 groups： ≥30 minutes group, unknown time group and ≤30 minutes group. The≤30 minutes group were further divided into 2 groups： standard-doses control group （32 cases）undergoing only intravenous injection of standard-dose epinephrine for more than 3 times, and observation treatment group （18 cases）undergoing standard-dose epinephrine without effect and then undergoing intravenous injection of posterior pituitary hormone. The effects were evaluated after 3 times of injection of resuscitation drug. Results Curative effects was

关 键 词：肾上腺素 垂体后叶激素 心跳骤停 心肺复苏 

分 类 号：R605.974[医药卫生—急诊医学]