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[小剂量垂体后叶素治疗小儿感染性休克24例报告]

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

作者信息

Yang Zi-jiang, Li Jing-feng, Fu Li-min, Lei Shang-bing, Liu Jun-hua, Wu Yong, Hu Yan-ping

机构信息

Department of Pediatrics, Hu Bei University of Medicine, Shiyan, China.

出版信息

Zhonghua Er Ke Za Zhi. 2011 Nov;49(11):858-61.

Abstract

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, glucocorticoid, 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.

摘要

目的

探讨小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月至2010年12月间48例经6小时常规治疗仍不能纠正休克的儿童感染性休克病例进行研究。患者随机分为两组(完全随机设计)(对照组24例,治疗组24例)。常规治疗包括抗生素/液体复苏/纠正酸碱失衡、糖皮质激素、器官(心/肺)支持,对照组持续泵入多巴胺1 - 15μg/(kg·min)和去甲肾上腺素0.5 - 2μg/(kg·min)。治疗组在最初6小时给予相同治疗,其余时间额外泵入小剂量垂体后叶素(0.01 - 0.03 U/min)。评估两组纠正休克的治疗效果。

结果

治疗组总有效率为76.2%,对照组为40.0%;死亡率分别为33.3%和60%。两组差异有统计学意义(P = 0.025)。

结论

对于经6小时常规治疗仍不能纠正休克的儿童感染性休克,小剂量垂体后叶素可显著提高临床疗效,缩短总治疗时间,降低死亡率。

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