Hunt B J
Rayne Institute, St Thomas' Hospital, London, UK.
Eur J Anaesthesiol Suppl. 1997 Mar;14:42-7; discussion 47-9. doi: 10.1097/00003643-199703001-00009.
Peri-operative bleeding is associated with invasive surgery and has traditionally been compensated for by blood transfusion. Concerns about the risk of transfusion-transmitted disease have led to an increasing interest in synthetic haemostatic agents. Desmopressin (1-deamino-8-D-arginine vasopressin), a synthetic analogue of vasopressin, has been shown to be of benefit in the peri-operative management of von Willebrand's disease or mild haemophilia A. This paper addresses the role of desmopressin and bleeding during invasive surgery, particularly during cardiopulmonary bypass. Clinical trials using desmopressin in open cardiac surgery indicate that it may reduce blood loss in those with an excessive bleeding tendency. However, it is difficult to identify this group pre-operatively.
围手术期出血与侵入性手术相关，传统上一直通过输血来补偿。对输血传播疾病风险的担忧导致人们对合成止血剂的兴趣日益增加。去氨加压素（1-去氨基-8-D-精氨酸加压素）是加压素的合成类似物，已被证明在血管性血友病或轻度甲型血友病的围手术期管理中有益。本文探讨了去氨加压素在侵入性手术期间，特别是在体外循环期间的作用及出血情况。在心脏直视手术中使用去氨加压素的临床试验表明，它可能减少有过度出血倾向患者的失血量。然而，术前很难确定这一群体。
