BACKGROUND Severe hyponatremia is considered a rare complication of pituitrin,which is widely used for the treatment of pulmonary hemorrhage.However,the management of pituitrin-associated hyponatremia can be challengi...BACKGROUND Severe hyponatremia is considered a rare complication of pituitrin,which is widely used for the treatment of pulmonary hemorrhage.However,the management of pituitrin-associated hyponatremia can be challenging because a rapid correction of hyponatremia may cause the development of osmotic demyelination syndrome,resulting in life-threatening neurological injuries.CASE SUMMARY A 20-year-old Chinese man with massive hemoptysis developed symptomatic hyponatremia(116 mmol/L)after therapy by a continuous intravenous drip of pituitrin.To normalize his serum sodium,a hypertonic saline infusion was applied for 3 d,and the pituitrin administration was stopped concurrently.Then,an overly rapid increase in serum sodium level(18 mmol/L in 24 h)was detected after treatment.One day later,the patient experienced a sudden onset of generalized tonic-clonic seizures,as well as subsequent dysarthria and dystonia.Magnetic resonance imaging revealed increased signal intensity in the bilateral symmetric basal ganglia on the T2-weighted images,compatible with a diagnosis of extrapontine myelinolysis.The patient received an intravenous administration of high-dose corticosteroids,rehabilitation,and neurotrophic therapy.Finally,his clinical abnormalities were vastly improved,and he was discharged with few residual symptoms.CONCLUSION Physicians should be fully aware that pituitrin can cause profound hyponatremia and its correction must be performed at a controlled rate to prevent the development of osmotic demyelination syndrome.展开更多
Objective: To study the curative effect of silybin combined with pituitrin-phentolamine for pulmonary tuberculosis complicated by acute hemoptysis. Methods: A total of 78 patients with pulmonary tuberculosis complicat...Objective: To study the curative effect of silybin combined with pituitrin-phentolamine for pulmonary tuberculosis complicated by acute hemoptysis. Methods: A total of 78 patients with pulmonary tuberculosis complicated by acute hemoptysis who were treated in this hospital between December 2013 and April 2017 were divided into control group (n=39) and silybin group (n=39) by random number table. Control group received pituitrin-phentolamine hemostasis therapy, silybin group received pituitrin-phentolamine combined with silybin therapy, both were treated for 1 week. The differences in peripheral blood liver function and coagulation index levels as well as serum oxidative stress index contents were compared between the two groups of patients before treatment and after 1 week of treatment. Results:Before treatment, the differences in peripheral blood liver function and coagulation index levels as well as serum oxidative stress index contents were not statistically significant between the two groups. After 1 week of treatment, peripheral blood liver function indexes ALT, AST, ALP and STB contents of silybin group were lower than those of control group;peripheral blood coagulation indexes PT, APTT and TT levels were lower than those of control group whereas Fib level was higher than that of control group;serum oxidative stress indexes AOPPs and LHP contents were lower than those of control group whereas GSH-Px and T-AOC contents were higher than those of control group. Conclusion: pituitrin-phentolamine combined with silybin therapy can effectively protect the liver function, optimize the coagulation function and reduce the oxidative stress response in patients with pulmonary tuberculosis complicated by acute hemoptysis.展开更多
目的探讨缩宫素联合垂体后叶素对宫缩乏力性产后出血患者纤溶、凝血功能的影响。方法便利抽样法选取2019年1月至2023年8月宫缩乏力性产后出血患者52例,按照随机数字表发分组即对照组和观察组,每组均26例,对照组使用缩宫素治疗,研究组采...目的探讨缩宫素联合垂体后叶素对宫缩乏力性产后出血患者纤溶、凝血功能的影响。方法便利抽样法选取2019年1月至2023年8月宫缩乏力性产后出血患者52例,按照随机数字表发分组即对照组和观察组,每组均26例,对照组使用缩宫素治疗,研究组采用缩宫素联合垂体后叶素的治疗方案,统计两组产后出血量、凝血功能指标、临床疗效、不良反应。结果观察组产后2h出血量(238.24±36.25 mL vs 279.32±42.71mL,t=3.739,P=0.001)、产后24h出血量(569.23±28.15mL vs 621.22±41.33mL,t=5.301,P<0.001)均显著低于对照组,且止血时间更短(21.11±3.22min vs 29.23±3.61min,t=8.559,P<0.001)。治疗后,观察组凝血酶时间(TT)、凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、D-二聚体(D-D)及纤维蛋白原(Fib)的改善差值均显著高于对照组(均P<0.001)。观察组临床总有效率为96.15%(25/26),显著高于对照组的76.92%(20/26)(χ^(2)=4.127,P=0.042)。两组不良反应总发生率比较,差异无统计学意义(23.08%vs15.38%,χ^(2)=0.495,P=0.482)。结论对于宫缩乏力性产后出血患者,在缩宫素基础上联合应用垂体后叶素,能更有效地减少产后出血量、缩短止血时间,并显著改善患者的纤溶与凝血功能,临床疗效确切,且未显著增加不良反应,安全性良好。展开更多
基金Supported by the Department of Health of Zhejiang Province,China,No.2016RCA013
文摘BACKGROUND Severe hyponatremia is considered a rare complication of pituitrin,which is widely used for the treatment of pulmonary hemorrhage.However,the management of pituitrin-associated hyponatremia can be challenging because a rapid correction of hyponatremia may cause the development of osmotic demyelination syndrome,resulting in life-threatening neurological injuries.CASE SUMMARY A 20-year-old Chinese man with massive hemoptysis developed symptomatic hyponatremia(116 mmol/L)after therapy by a continuous intravenous drip of pituitrin.To normalize his serum sodium,a hypertonic saline infusion was applied for 3 d,and the pituitrin administration was stopped concurrently.Then,an overly rapid increase in serum sodium level(18 mmol/L in 24 h)was detected after treatment.One day later,the patient experienced a sudden onset of generalized tonic-clonic seizures,as well as subsequent dysarthria and dystonia.Magnetic resonance imaging revealed increased signal intensity in the bilateral symmetric basal ganglia on the T2-weighted images,compatible with a diagnosis of extrapontine myelinolysis.The patient received an intravenous administration of high-dose corticosteroids,rehabilitation,and neurotrophic therapy.Finally,his clinical abnormalities were vastly improved,and he was discharged with few residual symptoms.CONCLUSION Physicians should be fully aware that pituitrin can cause profound hyponatremia and its correction must be performed at a controlled rate to prevent the development of osmotic demyelination syndrome.
文摘Objective: To study the curative effect of silybin combined with pituitrin-phentolamine for pulmonary tuberculosis complicated by acute hemoptysis. Methods: A total of 78 patients with pulmonary tuberculosis complicated by acute hemoptysis who were treated in this hospital between December 2013 and April 2017 were divided into control group (n=39) and silybin group (n=39) by random number table. Control group received pituitrin-phentolamine hemostasis therapy, silybin group received pituitrin-phentolamine combined with silybin therapy, both were treated for 1 week. The differences in peripheral blood liver function and coagulation index levels as well as serum oxidative stress index contents were compared between the two groups of patients before treatment and after 1 week of treatment. Results:Before treatment, the differences in peripheral blood liver function and coagulation index levels as well as serum oxidative stress index contents were not statistically significant between the two groups. After 1 week of treatment, peripheral blood liver function indexes ALT, AST, ALP and STB contents of silybin group were lower than those of control group;peripheral blood coagulation indexes PT, APTT and TT levels were lower than those of control group whereas Fib level was higher than that of control group;serum oxidative stress indexes AOPPs and LHP contents were lower than those of control group whereas GSH-Px and T-AOC contents were higher than those of control group. Conclusion: pituitrin-phentolamine combined with silybin therapy can effectively protect the liver function, optimize the coagulation function and reduce the oxidative stress response in patients with pulmonary tuberculosis complicated by acute hemoptysis.
文摘目的探讨缩宫素联合垂体后叶素对宫缩乏力性产后出血患者纤溶、凝血功能的影响。方法便利抽样法选取2019年1月至2023年8月宫缩乏力性产后出血患者52例,按照随机数字表发分组即对照组和观察组,每组均26例,对照组使用缩宫素治疗,研究组采用缩宫素联合垂体后叶素的治疗方案,统计两组产后出血量、凝血功能指标、临床疗效、不良反应。结果观察组产后2h出血量(238.24±36.25 mL vs 279.32±42.71mL,t=3.739,P=0.001)、产后24h出血量(569.23±28.15mL vs 621.22±41.33mL,t=5.301,P<0.001)均显著低于对照组,且止血时间更短(21.11±3.22min vs 29.23±3.61min,t=8.559,P<0.001)。治疗后,观察组凝血酶时间(TT)、凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、D-二聚体(D-D)及纤维蛋白原(Fib)的改善差值均显著高于对照组(均P<0.001)。观察组临床总有效率为96.15%(25/26),显著高于对照组的76.92%(20/26)(χ^(2)=4.127,P=0.042)。两组不良反应总发生率比较,差异无统计学意义(23.08%vs15.38%,χ^(2)=0.495,P=0.482)。结论对于宫缩乏力性产后出血患者,在缩宫素基础上联合应用垂体后叶素,能更有效地减少产后出血量、缩短止血时间,并显著改善患者的纤溶与凝血功能,临床疗效确切,且未显著增加不良反应,安全性良好。
