托尔瓦普坦早期给药对肝切除术后多流液的影响
Hiroya Iida1, Hiromitsu Maehira2, Haruki Mori2
1Department of Surgery, Shiga University of Medical Science, Seta Tsukinowa-Cho, Otsu, Shiga, 520-2192, Japan. hiroya@belle.shiga-med.ac.jp.
Langenbeck's archives of surgery
|October 16, 2023
概括
肝切除术后早期托尔瓦普坦的使用可以控制外流和体重增加. 然而,在接受肝脏手术的患者中,它没有降低肺吸收率或住院时间.
科学领域:
- 肝胆道手术 肝胆道手术
- 药理学 药理学是指药理学的学科.
- 腎臟病學 (nephrology) 是一種醫學專業.
背景情况:
- 胸腔溢液是肝切除术后的一个常见并发症.
- 术后流的有效管理策略对于患者的康复至关重要.
研究的目的:
- 评估早期托尔瓦普坦在肝切除术后控制术后外泄的疗效.
- 评估托尔瓦普坦对术后过程的影响,包括住院时间和并发症率.
主要方法:
- 一项随机对照试验比较托尔瓦普坦 (7.5毫克) 加上螺旋 (25毫克) 从术后的第1天到第5天与接受标准利尿剂护理的对照组.
- 主要终点是术后第5天计算机断层扫描时的多流量量.
- 其次性终点包括体重变化,肺吸收率和术后住院时间.
主要成果:
- 与对照组相比,托尔瓦普坦组在术后第五天显著减少了多流和体重增加 (分别p < 0.001和p = 0.019).
- 多变量分析确定了手术内流失的血液和延迟托尔瓦普坦的使用,作为多流的独立危险因素.
- 两组之间在肺吸收率或术后住院时间方面没有发现显著差异.
结论:
- 托尔瓦普坦的早期使用有效地控制了手术后的肺溢液和肝切除术后的体重增加.
- 托尔瓦普坦并没有显著降低膜吸收率,也没有缩短住院时间.
- 在手术期间流失的血液和延迟使用托尔瓦普坦是肝切除术后发生外流的关键危险因素.
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