血管麻痹综合征（vasoplegic syndrome,VS）广泛存在于各种休克晚期以及心血管等大手术后,其导致的持续性低血压是患者死亡的主要原因。亚甲蓝（methylene blue,MB)可用于充分扩容和应用大剂量血管活性药物后仍然无法改善的血管麻痹综合征患者，有观点认为亚甲蓝为治疗血管麻痹综合征的最后一道防线，在维持VS相关的血流动力学稳定中发挥至关重要的作用。但目前亚甲蓝在血管麻痹综合征的应用仍存在较大争议。本综述拟对亚甲蓝在治疗不同病因所致的VS中的疗效和安全性进行文献综述分析，并进一步介绍其作用机制、用法用量、副作用、适应症等特性，以期为临床工作中亚甲蓝的规范化使用提供依据
Vasoplegic syndrome was widely existed in all kinds of late shock and cardiac surgery. Methylene blue can be used in patients with vasoplegic syndrome who still cannot be improved after volume enlargement and large dose of vasoactive drugs. It is believed that methylene blue is the last therapy and may play an important role in vasoplegic syndrome. However, currently, less experience and some controversial existed in the use of methylene blue in patients with vasoplegic syndrome. In this article, the efficacy and safety of methylene blue in the treatment of various types of acute shock were reviewed, and the clinical characteristics, potential risk, pathogenesis and current therapy strategy were evaluated.
Cited
)
