去氨加压素和血凝酶在脊柱侧凸矫形手术中止血效果的比较

岭南现代临床外科 ›› 2010, Vol. 10 ›› Issue (01): 63-65.

去氨加压素和血凝酶在脊柱侧凸矫形手术中止血效果的比较

王仕红¹,赵一凡², 徐忠东²,彭林³

1. 广东省东莞市大岭山医院
2. 中山大学附属第二医院
3. 东莞市大岭山医院

通讯作者: 赵一凡

Effect of desmopressin and hemocoagulase on hemostatic function in scoliosis surgery.

Received:2010-01-14 Revised:2010-01-19 Online:2010-02-20 Published:2010-02-25

摘要/Abstract

摘要： 目的比较在脊柱侧凸矫形手术中，去氨加压素和立止血较少手术出血的效果，并观察其不良反应。方法 27例后路脊柱侧弯矫形手术，随机分为两组：血凝酶组（A组12例，血凝酶2kU术前半小时加至生理盐水100ml静脉滴注）和去氨加压素组（B组15例，去氨加压素0.3μg/kg，术前半小时加至生理盐水100ml静脉滴注）。连续记录用药后的动脉血压、心率、中心静脉压等血流动力学参数，在用药后15、30、60、120、180、240分钟测量全血ACT（激活凝血时间）值，记录手术失血量、手术期和术后24小时的尿量。结果在用药后10分钟，B组动脉平均压低于A组（P<0.05），以后均无明显差异；各时点ACT值无差异；两组患者术中出血量、输血量和总尿量无差异。结论去氨加压素静脉滴注可造成一过性血压下降，而术中对凝血功能、出血量和尿量的影响与血凝酶相比无差异。

关键词: 去氨加压素, 血凝酶, 脊柱侧凸矫形术, 激活凝血时间, Desmopressin, Hemocoagulase, Scoliosis surgery, ACT

Abstract: Objective To observe and compare the hemostatic effect of deamino-8-D-arginin vasopressin (DDAVP, desmopressin) and hemocoagulase in scoliosis surgery. Method Twenty-seven patients undergoing posterior reconstructive surgery for scoliosis were randomly assigned to either group A (n=12, hemocoagulase, 2KU) or group B (n=17, DDAVP, 0.3μg/kg). Mean arterial blood pressure (MAP), heart rate (HR) and central venous pressure (CVP) were continually monitored. Activated coagulation time (ACT) was recorded at 15, 30, 60, 120, 180, 240 minutes after transfusion of hemostatic drugs. Total blood loss, total urinary output during surgery and 24hr after surgery were also recorded. Result MAP at 10 minutes after hemostatic drug transfusion in group B was significantly lower than that in group A, P<0.05. There was no statistic deference between ACT data, total blood loss and urinary output in group A and B. Conclusion This study demonstrated that the hemostatic effect of DDAVP and hemocoagulase were similar. DDAVP did not alter the urinary output but caused brief systemic hypotension.

中图分类号:

R614.2

王仕红赵一凡徐忠东彭林. 去氨加压素和血凝酶在脊柱侧凸矫形手术中止血效果的比较[J]. 岭南现代临床外科, 2010, 10(01): 63-65.