醋酸去氨加压素减少经尿道前列腺电切手术出血的临床研究  

Acetate desmopressin reduced blood loss during transurethral resection of prostate

作　　者：陶佳意[1] 却晖 张劲松[1] 柳琦[1] 刘辉勇[1] 

机构地区：[1]湖北省黄冈市中心医院泌尿外科,湖北黄冈438000

出　　处：《中国现代医学杂志》2016年第19期114-116,共3页China Journal of Modern Medicine

摘　　要：目的观察醋酸去氨加压素(DDAVP)减少经尿道前列腺电切手术(TURP)失血的效果,评价其临床实用价值。方法选取择期行TURP患者60例,随机分为治疗组(30例)和对照组(30例)。治疗组术前予以醋酸去氨加压0.3μg/kg+0.9%生理盐200 ml静脉缓慢滴入,维持至手术完成。对照组予以0.9%生理盐200 ml静脉缓慢滴入,维持至手术完成。观察手术前后部分凝血活酶时间(APTT)、凝血因子Ⅷ促凝活性(FⅧ:C)、血红蛋白(Hb)及红细胞压积(Hct)的变化,比较手术时间、手术视野清晰度及膀胱冲洗液变清亮的天数;评价其临床疗效。结果治疗组较对照组手术后APTT缩短、FⅧ:C升高(P<0.05),两组Hb及Hct在术后2 h均降低(P<0.05),对照组降低更明显(P<0.05);治疗组手术中视野清晰,止血效果好,手术时间和膀胱冲洗液变清亮的天数较对照组缩短(P<0.05)。结论 DDAVP在TURP中能减少术中、术后出血量,可以根据患者病情选择应用。Objective To observe the effect of acetate desmopressin on reducing blood loss in transurethral resection of prostate（TURP）, and to evaluate its clinical value. Methods Sixty patients ready for TURP were randomly divided into treatment group（30 cases） and control group（30 cases）. The patients in the treatment group received slow intravenous infusion of acetate desmopressin 0.3 μg/kg dissolved in 200 ml normal saline,which was maintained till the surgery was completed. The patients in the control group received slow intravenous infusion of 200 ml normal saline till the end of the surgery. The partial thromboplastin time（APTT）, procoagulant activity of factor Ⅷ（FⅧ： C）, hemoglobin（Hb） and hematocrit（Hct） were measured before and after surgery. The operation time, the operation field definition and the number of days of bladder washing fluid becoming clear were compared between the two groups. The clinical effectiveness of acetate desmopressin was evaluated. Results Compared with the control group, APTT significantly reduced and FⅧ： C significantly increased after surgery in the treatment group（P〈0.05）. Hb and Hct in the two groups decreased 2 h after surgery（P〈0.05） which were more obvious in the control group（P〈0.05）. In the treatment group, the operation vision was clear, the hemostatic effect was good, and the operation time and the number of days bladder washing fluid became clear were significantly shorter than those in the control group（P〈0.05）. Conclusions Acetate desmopressin used for TURP can reduce blood loss, it can be applied according to the patient＇s condition.

关 键 词：去氨加压素 经尿道前列腺电切手术 出血 止血 

分 类 号：R699[医药卫生—泌尿科学]