精氨酸加压素对脊髓损伤所致自主神经反射异常患者难治性失血性休克的治疗效果。
Effectiveness of arginine vasopressin for the management of refractory hemorrhagic shock in a patient with autonomic dysreflexia caused by spinal cord injury.
作者信息
Shimauchi Tsukasa, Maki Jun, Yoshino Jun, Fujimura Naoyuki, Hoka Sumio
机构信息
Operating Rooms, Kyushu University Hospital, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan.
Emergency and Critical Care Center, Kyushu University Hospital, Fukuoka, Japan.
出版信息
JA Clin Rep. 2018 Nov 12;4(1):79. doi: 10.1186/s40981-018-0216-8.
BACKGROUND
Arginine vasopressin has been used for the management of refractory vasodilatory shock. However, it is still unclear whether arginine vasopressin is useful for hypotension in patients with spinal cord injury.
CASE DESCRIPTION
A 78-year-old man with autonomic dysreflexia and paralysis below the level corresponding to Th2 due to spinal cord injury previously underwent cholecystectomy. During the surgery, accidental hemorrhage led him to refractory hemorrhagic shock unresponsive to fluid resuscitation and catecholamine. Lasting hypotension was improved with arginine vasopressin.
CONCLUSION
We described a rare case report on the use of arginine vasopressin for management of refractory hemorrhagic shock in a patient with autonomic dysreflexia.
背景
精氨酸加压素已被用于治疗难治性血管舒张性休克。然而，精氨酸加压素对脊髓损伤患者的低血压是否有用仍不清楚。
病例描述
一名78岁男性，因脊髓损伤导致自主神经反射异常，且在相当于胸2水平以下瘫痪，此前接受过胆囊切除术。手术期间，意外出血导致他出现难治性失血性休克，对液体复苏和儿茶酚胺无反应。精氨酸加压素使持续的低血压得到改善。
结论
我们描述了一例罕见病例，即使用精氨酸加压素治疗一名患有自主神经反射异常患者的难治性失血性休克。
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