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目的观察醋酸去氨加压素注射液在手术前的应用对腹腔镜根治性前列腺切除术患者血清凝血因子及红细胞沉降率的影响。方法 124例局限性前列腺癌患者随机分为对照组62例与试验组62例,2组均给予常规对症治疗,对照组术前给予注射用哌拉西林钠舒巴坦钠2.5 g,每8 h滴注1次;试验组术前给予醋酸去氨加压素注射液0.35μg,每6~12 h滴注1次,2组患者均给药2次。取仰卧位,全麻进行腹腔镜根治性前列腺切除术。术后采取顺铂联合方案化疗,连用14 d。比较2组患者的临床疗效、治疗前后血清凝血因子(FⅡ、FⅦ、FⅧ、FⅨ、FⅩ)、红细胞沉降率(ESR)水平及药物不良反应发生情况。结果治疗后,对照组临床总有效率为80.65%(50/62例),试验组为93.55%(58/62例,P<0.05)。治疗后,试验组术中出血量为(552.93±56.29)m L,对照组为(760.29±78.35)m L(P<0.05)。治疗后,试验组FⅡ为(97.47±10.12)%,FⅦ为(98.54±10.47)%,FⅧ为(126.37±13.367)%,FⅨ为(103.37±11.46)%,FⅩ为(111.44±12.51)%,对照组分别为(85.25±8.67)%,(86.73±8.93)%,(116.47±12.68)%,(90.47±9.15)%,(90.57±9.26)%,差异有统计学意义(P<0.05)。试验组治疗后血清ESR为(17.94±1.84)mm·h~(-1),对照组为(26.46±3.73)mm·h~(-1)(P<0.05)。试验组药物不良反应主要表现为头痛、胃肠道反应、心动过速,药物不良反应发生率为8.06%(5/62例);对照组药物不良反应主要表现为头痛、血清肌酸酐轻度上升、胃肠道反应、皮疹,药物不良反应发生率为12.90%(8/62例),差异无统计学意义(P>0.05)。结论醋酸去氨加压素注射液在手术前的应用对腹腔镜根治性前列腺切除术患者的临床疗效显著,提高血清凝血因子,降低红细胞沉降率水平,安全性高。
Objective To observe the effect of preoperative application of desmopressin injection on serum coagulation factors and erythrocyte sedimentation rate in patients undergoing laparoscopic radical prostatectomy. Methods A total of 124 patients with localized prostate cancer were randomly divided into control group (n = 62) and experimental group (n = 62). The two groups were given conventional symptomatic treatment. The control group was given 2.5 g piperacillin sodium sulbactam Drip once; test group preoperative given desmopressine acetate injection 0.35μg, drip once every 6 ~ 12 h, 2 patients were given 2 times. Supine, general anesthesia for laparoscopic radical prostatectomy. Cisplatin combined chemotherapy after surgery, once every 14 days. The clinical curative effect of two groups were compared. The levels of serum coagulation factors (FⅡ, FⅦ, FⅧ, FIX, F Ⅹ), erythrocyte sedimentation rate (ESR) and adverse reactions of drugs before and after treatment were compared. Results After treatment, the total effective rate of the control group was 80.65% (50/62 cases), and the experimental group was 93.55% (58/62 cases, P <0.05). After treatment, the blood loss in the experimental group was (552.93 ± 56.29) m L and that in the control group was (760.29 ± 78.35) m L (P <0.05). After treatment, FⅡ was (97.47 ± 10.12)%, FⅦ was (98.54 ± 10.47)%, FⅧ was (126.37 ± 13.367)%, FⅨ was (103.37 ± 11.46)% and F X was (111.44 ± 12.51) The control group were (85.25 ± 8.67)%, (86.73 ± 8.93)%, (116.47 ± 12.68)%, (90.47 ± 9.15)% and (90.57 ± 9.26)%, respectively, with statistical significance (P <0.05). The ESR of the experimental group was (17.94 ± 1.84) mm · h -1 after the treatment, and (26.46 ± 3.73) mm · h -1 (P <0.05) in the control group. Adverse drug reactions in the experimental group were mainly headache, gastrointestinal reactions, tachycardia, adverse drug reactions occurred in 8.06% (5/62 cases); adverse drug reactions in the control group mainly manifested as headache, serum creatinine slightly increased , Gastrointestinal reaction, skin rash and adverse drug reaction rate was 12.90% (8/62 cases), the difference was not statistically significant (P> 0.05). Conclusion Preoperative application of desmopressin acetate injection in patients undergoing laparoscopic radical prostatectomy has significant clinical efficacy, increased serum clotting factor, reduced erythrocyte sedimentation rate and high safety.