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目的:观察醋酸去氨加压素(desmopressin acetate,DDAVP)对食管癌根治术中患者血压、心率、出血量、手术时间的影响。方法:食管癌患者120例,ASAⅠ~Ⅱ级,年龄46~78岁,既往无胸腔内手术史,无严重心、脑、肺、肝、肾等重要脏器疾病,无高血压,排除有胸腔严重粘连的患者。随机分为生理盐水对照组和DDAVP实验组,每组60例。实验组手术开始前10 min经静脉泵注DDAVP 0.6μg/(kg·h),总剂量为0.3μg/kg。对照组以等体积生理盐水处理。观察两组麻醉前(T1)、手术开始时(T2)、手术10 min(T3)、手术30 min(T4)、手术60 min(T5)和手术结束(T6)时的收缩压/舒张压、心率,应用称重法测量两组患者术中出血量,记录两组患者的手术时间。结果:实验组患者T2、T3、T4时收缩压/舒张压低于对照组,差异有统计学意义(P<0.05);各时间点两组患者心率比较差异无统计学意义。实验组患者术中出血量显著低于对照组(P<0.05),实验组患者手术时间显著低于对照组(P<0.05)。结论:DDAVP能够一过性降低食管癌患者术中血压,减少出血量,缩短手术时间,效果确切。
Objective: To observe the effects of DDAVP on blood pressure, heart rate, blood loss and operation time in esophageal cancer patients undergoing radical operation. Methods: 120 patients with esophageal cancer, ASA Ⅰ ~ Ⅱ grade, aged 46 to 78 years old, no previous intrathoracic surgery history, no serious heart, brain, lung, liver and kidney disease and other important organs, no hypertension, excluding the chest Serious adhesion of patients. Randomly divided into saline control group and DDAVP experimental group, 60 cases in each group. The experimental group received intravenous infusion of DDAVP 0.6 μg / (kg · h) 10 min before the start of surgery, and the total dose was 0.3 μg / kg. The control group was treated with an equal volume of normal saline. The systolic / diastolic blood pressures were measured before anesthesia (T1), at the beginning of operation (T2), at 10 min (T3), at 30 min (T4), at 60 min (T5) and at the end of operation Heart rate, application of weighing method to measure the amount of bleeding in two groups of patients, recording the operation time of two groups of patients. Results: The systolic blood pressure and diastolic blood pressure were lower in the experimental group than those in the control group at T2, T3 and T4 (P <0.05). There was no significant difference in heart rate between the two groups at each time point. The bleeding volume in the experimental group was significantly lower than that in the control group (P <0.05). The operation time in the experimental group was significantly lower than that in the control group (P <0.05). Conclusion: DDAVP can transiently reduce intraoperative blood pressure, reduce the amount of bleeding and shorten the operation time in esophageal cancer patients.