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頁籤選單縮合
題 名 | 血管加壓素在重症病人之應用=The Use of Vasopressin in Critical Ill Patients |
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作 者 | 葉春長; 吳慶堂; 汪志雄; | 書刊名 | 中華民國重症醫學雜誌 |
卷 期 | 4:4 2002.10[民91.10] |
頁 次 | 頁251-260 |
分類號 | 418.22 |
關鍵詞 | 血管加壓素; 作用機轉; 血管擴張性休克; 出血性休克; 心跳停止; Vasopressin; Vasodilatory shock; Hemorrhagic shock; Cardiac arrest; |
語 文 | 中文(Chinese) |
中文摘要 | 隨著重症加護醫學的進步,臨床上治療重症病人時不僅藥物之作用機轉、相關之副作用已逐漸被探究清楚,如何在適當時機將適當劑量之藥物靈活應亦是重要之課題。血管加壓素(vasopressin)在臨床上已經使用超過五十年,過去主要用來治療食道靜脈曲張破裂出血和尿崩症。近年來,血管加壓素在重症領域上,不論是在2000年版高級心臟救命術中,已被建議當作腎上腺素(adrenaline, epinephrine)的替代性藥物,使用於心跳停止病人,促進其恢復自主性循環;近幾年來有更多篇綜合性文獻報告指出:血管加壓素不僅有獨特於其他兒茶胺(catecholamines)藥物的作用,其更可能具有抑制某些因休克狀態時所導致之病態性血管擴張的獨特作用,而被應用於治療因心室顫動所引起之低血壓、敗血症或開心手術行體外循環後所引起之血管擴張性休克及出血性休克。有鑑於其在處理重症病人上日趨重要,本文除將血管加壓素之病生理及藥理機轉分別敘述外,並將目前血管加壓素在相關性動物研究及實際人類臨床應用上加以探討分析,期能提供臨床工作者治療重症病患之參考。 |
英文摘要 | With the progress of intensive care medicine, the mechanisms and adverse effects of drugs have been investigated clearly. However, how to use drugs properly with proper dosage under appropriate situations is still not clearly documented. Vasopressin has been used clinically over five decades, mainly for treating variceal hemorrhage and diabetes insipidus. In the area of critical care medicine, vaopressin is now emerging as a rational therapy in the management of some critical ill patients with beneficial effect. According to the 2000 guidelines for the advanced cardiovascular life support, it is known that vasopressin may be as an alternative drug to adrenaline for cardiac arrest patients. In this review, we outline the physiology and pharmacology, and the indications and administration guidelines of vasopressin used in critical care medicine. We also give an overview of the evidence and clinical literatures supporting the use of vasopressin in critical ill patients with vasodilatory shock (after cardiopulmonary bypass, septic shock), cardiac arrest, ventricular fibrillation and late-stage hemorrhage shock. Hopefully, it will offer the physicians of the intensive care medicine a guide for vasopressin treatment. |
本系統中英文摘要資訊取自各篇刊載內容。