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| Effect of desmopressin on perioperative bleeding and thrombogenesis in surgery of vein varicose |
| Received:June 20, 2020 |
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| DOI：10.11915/j.issn.1671-5403.2021.05.067 |
| Key words:deamino arginine vasopressin coagulation factor perioperative hemorrhage thrombus This work was supported by Major Research Program of National Natural Science Foundation of China |
| Author Name | Affiliation | E-mail | | XU Fang | Department of Vascular Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing 100730, China
Department of Surgery, Graduate School, Hebei North University, Zhangjiakou 075000, Hebei Province, China | yuehongzheng@yahoo.comeffect | | WANG Zi-Jian | Department of Vascular Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing 100730, China | yuehongzheng@yahoo.comeffect | | LI Sheng-Nan | Department of Vascular Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing 100730, China | yuehongzheng@yahoo.comeffect | | CHEN Yue-Xin | Department of Vascular Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing 100730, China | yuehongzheng@yahoo.comeffect | | GAO Tian | Department of Bone and Soft Tissue Tumor, Beijing Cancer Hospital, Beijing 100142, China | yuehongzheng@yahoo.comeffect | | HAN Bin | Department of Urology, Shengjing Hospital of China Medical University, Shenyang 110004, China | yuehongzheng@yahoo.comeffect | | KONG Xiang-Qian | Department of Vascular Surgery, Shandong Provincial Hospital, Ji′nan 250021, China | yuehongzheng@yahoo.comeffect | | WANG Fan | Department of Vascular Surgery, Linyi Municipal People′s Hospital, Linyi 276100, Shandong Province, China | yuehongzheng@yahoo.comeffect | | ZHENG Yue-Hong | Department of Vascular Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing 100730, China | yuehongzheng@yahoo.comeffect |
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| Abstract: |
| Objective To evaluate the effect of perioperative administration of desmopressin on perioperative bleeding and postoperative blood test indexes in patients receiving varicose vein, urological and orthopedic surgeries. Methods This prospective study randomly enrolled 182 patients who underwent great saphenous varicose vein surgery, or urological or orthopedic surgery in Peking Union Medical College Hospital of Chinese Academy of Medical Sciences, Beijing Cancer Hospital, Shengjing Hospital of China Medical University, Shandong Provincial Hospital, and Linyi Municipal People′s Hospital between January 2018 and July 2019. The patients were randomly divided into desmopressin group (n=98) and control group (n=84), each group being further divided into three subgroups:varicose vein surgery, orthopedic surgery, and urological surgery. The two groups were compared in hemoglobin, platelets, sodium, alanine aminotransferase, serum creatinine, prothrombin time(PT), D-dimer, activated partial thromboplastin time (APTT), fibrinogen(Fb), postoperative hemorrhages, intraoperative bleeding volume and postoperative ecchymosis area. SPSS 26.0 was used for statistical analysis. Data comparison between two groups was performed usingχ2test, U test, t test or Fisher exact test. Results On postoperative day 1, Na+ level in the varicose vein and orthopedic surgery subgroups, APTT in the varicose surgery subgroup, and PT in the orthopedic surgery subgroup were all lower in the desmopressin group than in the corresponding subgroups of the control group, the differences being statistically significant (P<0.05 for all). On postoperative day 2, Na+ and Fb in the varicose vein and orthopedic surgery subgroups were lower in the desmopressin group than in those of the control group, the differences being statistically significant (P<0.05 for all). Serum creatinine in the control group was lower on postoperative day 1 and 2 than that before the surgery with statistically significant differences (P<0.05 for all). There was no significant differences in other indexes. Postoperative ecchymosis occurred in more patients in the varicose vein surgery subgroup of the desmopressin group [16(32.7%)] than that of the control group [16(41.0%)], and the single area of ecchymosis in the desmopressin group [0.220 cm2 (0.155 cm2, 0.580 cm2)] was significantly lower than that in the control group [0.315 cm2(0.163 cm2,1.475 cm2)], with a statistically significant difference (P<0.05). Conclusion The perioperative use of desmopressin affects blood indexes, effectively reducing the area of postoperative ecchymosis in large saphenous varicose veins and the incidence of bleeding and deep vein thrombosis. |
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