Effect of arginine vasopressin on systemic hemodynamicsin vasodilatoryvasoplegic syndrome patients following cardiopulmonary bypass
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摘要: 目的 评价血管加压素对心肺转流术(CPB)后血管麻痹综合征患者血流动力学的影响.方法 选取CPB下心脏手术后发生血管麻痹综合征患者14例,分为去甲肾上腺素(NE)组(NE组)和血管加压素(AVP)组(AVP组).NE组患者输注NE维持平均动脉血压＞65 mmHg,当NE输注速率>0.4 μg/(kg·min)则加用AVP 0.01～0.04 U/min; AVP组患者输注AVP 0.01～0.04 U/min,必要时使用NE维持患者平均动脉血压＞65 mmHg.于血管麻痹综合征诊断时(T1,基础值)、注药后24 h(T2)、48 h(T3)、72 h(T4)分别记录两组患者心率(HR)、平均动脉压(MAP)、平均肺动脉压(MPAP)、心排血量(CO)、肺毛细血管楔压(PCWP)、中心静脉压(CVP)及尿量,计算体循环血管阻力(SVR)及肺循环血管阻力(PVR).并记录儿茶酚胺药物使用量及不良反应.结果 两组患者年龄、体重、性别构成比,术前EF、术前治疗用药情况、CPB时间、主动脉阻断时间比较差异无统计学意义(P>0.05).两组患者血压维持稳定.与NE组比较,AVP组SVR T2时增加; HR T2～3时显著降低(P<0.05); NE需要量T2～4明显降低(P<0.05); 尿量明显增加(P<0.05).结论 AVP可以改善CPB术后血管麻痹综合征患者的血流动力学.
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