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西地那非对 TCPC 手术后胸腔和腹腔积液的影响。

The effect of sildenafil on pleural and peritoneal effusions after the TCPC operation.

机构信息

Department of Anesthesia and Intensive Care, Children's Hospital, Helsinki University Hospital, Helsinki, Finland.

Faculty of Medicine, University of Helsinki, Helsinki, Finland.

出版信息

Acta Anaesthesiol Scand. 2019 Nov;63(10):1384-1389. doi: 10.1111/aas.13431. Epub 2019 Jul 16.

Abstract

BACKGROUND

We evaluated whether the administration of sildenafil in children undergoing the TCPC operation shortened the interval from the operation to the removal of the pleural and peritoneal drains.

METHODS

We retrospectively reviewed the data of 122 patients who had undergone the TCPC operation between 2004 and 2014. Patients were divided into two groups on the basis of their treatments. Sildenafil was orally administered pre-operatively in the morning of the procedure or within 24 hours after the TCPC operation to the sildenafil group (n = 48), which was compared to a control group (n = 60). Fourteen patients were excluded from the study.

RESULTS

The primary outcome measure was the time from the operation to the removal of the drains. The study groups had similar demographics. The median [interquartile range] time for the removal of drains (sildenafil group 11 [8-19] vs control group 11 [7-16] d, P = .532) was comparable between the groups. The median [interquartile range] fluid balance on the first post-operative day was significantly higher (P = .001) in the sildenafil group compared with controls (47 [12-103] vs 7 [-6-67] mL kg ). The first post-operative day fluid balance was a significant predictor for a prolonged need for drains in the multivariate analysis.

CONCLUSIONS

Sildenafil administration, pre-operatively or within 24 hours after the TCPC operation, did not reduce the required time for pleural and peritoneal drains but was associated with a significantly higher positive fluid balance.

摘要

背景

我们评估了西地那非在接受 TCPC 手术的儿童中的应用是否缩短了从手术到胸腔和腹腔引流管拔除的时间间隔。

方法

我们回顾性分析了 2004 年至 2014 年间接受 TCPC 手术的 122 例患者的数据。根据治疗方法将患者分为两组。西地那非组(n=48)于术前上午或 TCPC 手术后 24 小时内口服西地那非,与对照组(n=60)进行比较。14 例患者被排除在研究之外。

结果

主要观察指标是从手术到引流管拔除的时间。两组患者的一般资料相似。引流管拔除的中位数[四分位间距]时间(西地那非组 11[8-19]天 vs 对照组 11[7-16]天,P=0.532)在两组间无差异。术后第 1 天的中位[四分位间距]液体平衡在西地那非组明显高于对照组(47[12-103]vs 7[-6-67]mL·kg)(P=0.001)。多变量分析显示,术后第 1 天的液体平衡是引流管留置时间延长的显著预测因素。

结论

西地那非术前或 TCPC 手术后 24 小时内给药并未减少胸腔和腹腔引流管的留置时间,但与明显更高的正液体平衡相关。

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