术前使用醋酸去氨加压素减少肾衰竭出血：它真的有效吗？

Pre-procedure desmopressin acetate to reduce bleeding in renal failure: does it really work?

作者信息

Radhakrishnan Seetha, Chanchlani Rahul, Connolly Bairbre, Langlois Valerie

机构信息

Division of Nephrology, Department of Pediatrics, Hospital for Sick Children, Toronto, Ont., Canada.

出版信息

Nephron Clin Pract. 2014;128(1-2):45-8. doi: 10.1159/000362455. Epub 2014 Oct 23.

DOI:10.1159/000362455

PMID:25373723

Abstract

BACKGROUND

Desmopressin (DDAVP) is often used prior to procedures to minimize bleeding in patients with renal failure; however, there is little evidence to support this practice. The objectives of this study were to evaluate the practice of administration of DDAVP prior to procedures within our division and to determine the number of bleeding episodes for patients who received DDAVP compared to those who did not.

METHODS

Hospital records of patients who underwent renal biopsy or central line placement between April 2006 and March 2008 were reviewed. Patients with glomerular filtration rate (GFR) <60 ml/min/1.73 m(2) were identified and subcategorized into three groups: group A GFR <15 ml/min/1.73 m(2), group B GFR 15-29 ml/min/1.73 m(2), and group C GFR 30-60 ml/min/1.73 m(2). The number of bleeding events was noted in each group.

RESULTS

No significant difference was found in the number of bleeding events between those who received and did not receive DDAVP overall and in each GFR group. A possible trend towards the benefit with treatment in group A was observed.

CONCLUSION

There was no significant reduction in bleeding for those who received DDAVP which questions the validity of this practice. Patients with GFR <15 ml/min/1.73 m(2) may possibly derive benefit.

摘要

背景

去氨加压素（DDAVP）常在手术前用于减少肾衰竭患者的出血；然而，几乎没有证据支持这种做法。本研究的目的是评估我们科室在手术前使用DDAVP的情况，并确定接受DDAVP治疗的患者与未接受治疗的患者的出血事件数量。

方法

回顾了2006年4月至2008年3月期间接受肾活检或中心静脉置管的患者的医院记录。确定肾小球滤过率（GFR）<60 ml/min/1.73 m²的患者，并将其分为三组：A组GFR<15 ml/min/1.73 m²，B组GFR 15-29 ml/min/1.73 m²，C组GFR 30-60 ml/min/1.73 m²。记录每组的出血事件数量。