去氨加压素减少乳腺癌根治术出血量的临床研究

Role of desmopressin in reducing blood loss following breast cancer radical operation

目的:观察去氨加压素(DDAVP)用于乳腺癌根治手术减少患者出血量的效果,评价其临床实用价值.方法:择期行乳腺癌根治手术的患者60例,随机分成治疗组(n=30)和对照组(n=30),治疗组于术前30min将DDAVP 0.3μg/kg用生理盐水稀释到100mL静滴,对照组输入等量生理盐水.测定两组用药前和术后的血小板计数(PLT)、凝血酶原时间(PT)、部分凝血活酶时间(APTT)、纤维蛋白原定量(FIB)、第八因子促凝活性(FⅧ∶C);记录手术时间和手术开始至24h中出血量,评价其临床效果.结果:治疗组:APTT用药后(29.6±1.0)和用药前(35.0±1.0)相比显著缩短,用药后(176±10)和用药前(112±11)相比FⅧ∶C显著升高(P<0.05),治疗组和对照组相比术中出血量和手术时间减少(P<0.05).结论:DDAVP可明显增强乳腺癌根治术患者的凝血功能,减少乳腺癌手术的出血量.

AIM： To observe the effects of desmopressin （DDAVP） on reducing blood loss following breast cancer radical operation so as to evaluate its clinical values. METHODS： Sixty patients with breast cancer, who was about to undergo selective radical operation, were randomly allocated into treatment group and control group, with 30 in each group. The treatment group received DDAVP（0.3 g/kg diluted in 100 mL normal saline） at 30 rain preoperatively. The control group received same volume of normal saline instead. The platelet （PLT）, prothrombin time （ PT）, activated partial thromboplastin time （ APTT）, fibrinogen （FIB）, factorⅧ coagulator（ FⅧ C） activity, the operation duration, and blood loss within postoperative 24 h were determined and compared between 2 groups. RESULTS ： In treatment group, APTT was significantly shorter after drug administration （29.6 ± 1.0） than before drug administration （35.0 ±1.0, P 〈0.05） ; FⅧ activity was significantly higher after drug administration （176 ±10） than before drug administration （ 112 ±11, P 〈 0.05）. The operation duration and blood loss reduced significantly in treatment group compared with control group （ P 〈 0.05 ）. CONCLUSION： DDVAP can enhance the hemostatic function of breast cancer patients, and reduce the blood loss following breast cancer radical operation.