血管加压素治疗感染性休克的临床进展

摘要

感染性休克是脓毒症的严重阶段,住院病死率超过40%,其主要病理生理改变是血管扩张、通透性增加.临床上通常采用液体复苏、儿茶酚胺类缩血管活性药物,以维持重要器官的灌注压,然而在感染状态时,血管对儿茶酚胺类药物的反应性降低,大剂量应用去甲肾上腺素或多巴胺会产生明显副作用.近来研究表明,血管加压素(AVP)可改善感染性休克患者血流动力学,增加组织灌注,并且与去甲肾上腺素有协同作用,在感染性休克的治疗中表现出良好的应用前景.本文通过对AVP在感染性休克患者中的应用进行综述,以期为临床运用提供参考.%Septic shock is a serious stage of sepsis with a hospital mortality rate of more than 40%. The pathophysiology of septic shock is vasodilation and increased permeability. Fluid resuscitation, vasopressor drugs are usually used to maintain the perfusion pressure of the main organs. However, infectious patients usually have the irresponsive vessel to catecholamines and may lead to obvious side effects using high doses of norepinephrine or dopamine. Recent studies have shown that vasopressin (AVP) improves hemodynamics, increases tissue perfusion, and synergizes with norepinephrine in patients with septic shock, showing extent application prospects in the treatment of septic shock. The practice of AVP in septic shock is reviewed in this article in order to provide a reference for clinicians.