Kapapa Thomas, Röhrer Stefan, Struve Sabine, Petscher Matthias, König Ralph, Wirtz Christian Rainer, Woischneck Dieter
Neurochirurgische Klinik, Universitätsklinikum Ulm, Albert-Einstein-Allee 23, 89081 Ulm, Germany.
Klinik für Hämatologie, Onkologie, Immunologie, Palliativmedizin, Infektiologie und Tropenmedizin, Städtisches Klinikum München, Klinikum Schwabing, Kölner Platz 1, 80804 München, Germany.
Neurol Res Int. 2014;2014:298767. doi: 10.1155/2014/298767. Epub 2014 Dec 23.
Introduction. The secondary increase in the size of intracranial haematomas as a result of spontaneous haemorrhage or trauma is of particular relevance in the event of prior intake of platelet aggregation inhibitors. We describe the effect of desmopressin acetate as a means of temporarily stabilising the platelet function. Patients and Methods. The platelet function was analysed in 10 patients who had received single (N = 4) or multiple (N = 6) doses of acetylsalicylic acid and 3 patients (control group) who had not taken acetylsalicylic acid. All subjects had suffered intracranial haemorrhage. Analysis was performed before, half an hour and three hours after administration of desmopressin acetate. Statistical analysis was performed by applying a level of significance of P ≤ 0.05. Results. (1) Platelet function returned to normal 30 minutes after administration of desmopressin acetate. (2) The platelet function worsened again after three hours. (3) There were no complications related to electrolytes or fluid balance. Conclusion. Desmopressin acetate can stabilise the platelet function in neurosurgical patients who have received acetylsalicylic acid prior to surgery without causing transfusion-related side effects or a loss of time. The effect is, however, limited and influenced by the frequency of drug intake. Further controls are needed in neurosurgical patients.
引言。在自发性出血或创伤后,颅内血肿大小的继发性增加在之前服用血小板聚集抑制剂的情况下具有特殊意义。我们描述了醋酸去氨加压素作为一种暂时稳定血小板功能方法的效果。患者与方法。对10例接受过单剂量(N = 4)或多剂量(N = 6)乙酰水杨酸的患者以及3例未服用乙酰水杨酸的患者(对照组)的血小板功能进行分析。所有受试者均发生了颅内出血。在给予醋酸去氨加压素之前、半小时和三小时后进行分析。采用P≤0.05的显著性水平进行统计分析。结果。(1)给予醋酸去氨加压素30分钟后血小板功能恢复正常。(2)三小时后血小板功能再次恶化。(3)未出现与电解质或液体平衡相关的并发症。结论。醋酸去氨加压素可使术前接受过乙酰水杨酸治疗的神经外科患者的血小板功能稳定,且不会引起输血相关的副作用或时间浪费。然而,这种效果是有限的,并且受药物摄入频率的影响。神经外科患者需要进一步的对照研究。