摘要
目的观察去氨加压素（ＤＤＡＶＰ）对体外循环术后出血及凝血功能的影响，评价其临床实用价值。方法择期手术的非紫绀性先心病病人４１例 ＡＳＡⅠ—Ⅱ级，随机分为对照组（ｎ＝２１），用药组（ｎ＝２０），采用双盲法进行试验，用药组在鱼精蛋白中和肝素后 １５ｍｉｎ， ＡＣＴ＜ １３０ｓ后，ＤＤＡＶＰ０．３μｇ／ｋｇ稀释至 ５０ｍｌ， １５ｍｉｎ静脉输入，对照组输入等量生理盐水，测定两组病人术前、鱼精蛋白中和肝素后和用药 １ｈ的血球压积、血小板计数、血小板聚集率、血管性假血友病因子（ｖｏｎ ＷｉｌｌｅｂｒａｎｄＦａｃｔｏｒ，ｖＷＦ）、第八因子促凝活性（ＦⅧ：Ｃ），记录术后２４ｈ出血量。结果用药组用药１ｈ血浆ｖＷＦ浓度和 ＦⅧ： Ｃ明显高于对照组（ Ｐ＜ ０． ０５）；比术前及中和肝素后，血浆 ｖＷＦ浓度和 ＦⅧ： Ｃ显著性升高（Ｐ＜０．０１），血小板计数和血小板聚集率两组比较无显著性差异（Ｐ＞０．０５）；术后２４ｈ出血量用药组比对照组明显减少（ Ｐ＜ ０． ０５）。结论 ＤＤＡＶＰ可增强体外循环患者的凝血功能，明显减少体外循环术后出血。
Objective To observe the influence of desmopressin acetate (DDAVP) on blood loss and hemostatic function after cardiac surgery with extracorpoteal circulation.Methods Forty-one patients undergoing congenital heart operations, were randomly allocated to double--blindly receiving 0.3ug/kg DDAVP in a 50 ml saline(group DDAVP, n = 20) and 50ml normal saline (group placebo, n = 21) over 15 min after protamine infusion. Blood samples were obtained before operation, immediately before studied drug administration and 1 h after the administration, to measure the hematocrit, platelet count and aggregation, Factor Ⅷ coagulant activity and von Willebrand factor (vWF) concentration. Results The first postoperative 24-hour blood loss was significantly lower in group DDAVP than in group placebo [ (178 ± 90) ml vs (291 ± 98 ) ml, P < 0.05 ]. There were not significant differeces in platelet count and aggregation between both groups (P > 0 .05); The plasma level of vWF and factor Ⅷ coagulant activity markedly increased 1h after DDAVP administration as compared with those in group placebo, before operation and after protamine infusion in group DDAVP (P < 0.05 ). Conclusions The administration of DDAVP can increase the hemostatic function to reduce the blood loss in patients undergoing cardiac operations with cardiopulmonary bypass.
出处
《中华麻醉学杂志》
CAS
CSCD
北大核心
2000年第7期403-405,共3页
Chinese Journal of Anesthesiology
关键词
去氨加压素
心肺转流术
血小板
体外循环
Desmopressin
Cardiopulmonary bypass
Platelet
von Willebrand factor
Factor Ⅳ
