八胺和血管压缩剂作为内科手术癌症危机的第一线治疗方法的比较
Belinda H McCully1, Kaiya Kozuma2, SuEllen Pommier2
1Department of Basic Medical Sciences, College of Osteopathic Medicine of the Pacific-Northwest, Western University of Health Sciences, Lebanon, OR, USA.
Annals of surgical oncology
|January 16, 2024
概括
奥克特雷奥提德在治疗手术内癌症危机时无效. 血管压缩剂是一种更有效的第一线治疗,导致神经内分泌瘤手术期间的危机持续时间更短,并发症更少.
科学领域:
- 麻醉学 麻醉学
- 内分泌学 在内分泌学.
- 手术瘤学手术瘤学
背景情况:
- 在神经内分泌瘤手术期间,手术期间的癌危机呈现为突然的低血压.
- 从历史上看,八类被用于预防和治疗,据推测是由于荷尔蒙释放.
- 最近的证据表明,奥克胺是无效的,大规模的激素释放不会发生.
研究的目的:
- 为了评估奥克胺与血管压缩剂的疗效,作为手术内癌症危机的第一线治疗.
- 为了比较与不同一线治疗方案相关的结果.
主要方法:
- 对潜在的癌性麻醉数据库的分析.
- 基于八丁和血管压缩剂的第一线治疗方案之间的结果比较.
- 使用学生的t测试,曼-惠特尼U测试和费舍尔的精确测试进行统计分析.
主要成果:
- 八胺 (n=150) 导致30%的患者发生危机,平均持续时间为6分钟,93%需要随后的血管压缩剂.
- 血管压缩剂 (n=195) 在25%的患者 (p=0.31) 中导致危机,平均持续时间为3分钟 (p<0.001).
- 血管压力剂组的危机持续时间较短,危机较少,没有中断的手术,麻醉时间较短 (p<0.05).
结论:
- 一线性八胺在手术内癌症危机中无效,往往需要血管压缩剂.
- 第一线血管压缩剂显著缩短了危机持续时间,并减少了并发症.
- 治疗指南应该更新,以推血管压缩剂作为手术内癌症危机的第一线治疗.
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