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Title:: Application of vasopressin and norepinephrine in treatment of infants with vasodilator shock after complicated cardiac surgerg

作者:: 祁明¹; 郑萍¹1; 黄维勤²; 袁婷²; 袁辉²; (武汉亚洲心脏病医院：1.ICU，2.麻醉科，湖北武汉 430022)

Author(s):: QI Ming¹; ZHENG Ping¹; HUANG Wei qin²; YUAN Ting²; YUAN Hui²; (1.Cardiovascular Surgery ICU, 2.Department of Anesthesiology, Wuhan Asia Heart Hospital, Wuhan 430022, Hubei, China

关键词:: 血管加压素; 心脏外科手术; 血管舒张性休克; 血流动力学

Keywords:: vasopressin; cardiac surgery; vasodilator shock; hemodynamics

分类号:: R541.1;R972

DOI:: -

文献标识码:: A

摘要:: 目的:比较血管加压素（AVP）和去甲肾上腺素（NE）对婴幼儿复杂先天性心脏病手术后血管舒张性休克患者的疗效。方法:回顾性总结2010年6月~2012年10月32例心脏术后早期使用小剂量AVP的复杂婴幼儿心脏手术患者（试药组），与2008年8月~2010年5月实施的另外35例早期使用去甲肾上腺素（NE）的复杂婴幼儿心脏手术患者（对照组）的临床资料进行比较。结果:两组患者基本资料、心率、血压、中心静脉压、最高乳酸值、最低中心静脉血氧饱和度（ScvO2）、静动脉二氧化碳分压差（Pcv-aCO2）、尿量、胸引量组间差异不显著；AVP组血管活性药物评分更低、心率失常发生率更低、呼吸机辅助时间及住监护室时间减少。结论:AVP改善体外循环下术后血管舒张性休克患者的疗效优于NE。

Abstract:: AIM:To evaluate the hemodynamic effects of vasopressin in patients with vasodilator shock after cardiac operation. METHODS: A retrospective review was conducted and compared in 32 cases of infants who underwent complex cardiac operation from June 2010 to October 2012 and were treated with early use of small doses of AVP postoperatively and 35 cases of infants who underwent the same operation from August 2008 to May 2010 but were treated with early use of norepinephrine postoperatively. RESULTS: No significant difference was found between groups in basic data, heart rate, blood pressure, central venous pressure, maximum lactate value, minimum of ScvO2, Pcv-aCO2, urine volume and chest drainage. However, in AVP group, the vasoactive drug score and rate of arrhythmia were lower, and the time of mechanical ventilation and length of stay in ICU was reduced. CONCLUSION: AVP improves postoperative hemodynamics in patients suffering from vasodilator shock after cardiopulmonary bypass.

参考文献/References

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两种血管升压药物治疗婴幼儿复杂心脏手术后血管舒张性休克的疗效比较

《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

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