Nocturnal enuresis often causes considerable distress or functional impairment to patient and their parents necessitating a multidisciplinary approach from paediatrician, paediatric nephrologist, urologists and psychi...Nocturnal enuresis often causes considerable distress or functional impairment to patient and their parents necessitating a multidisciplinary approach from paediatrician, paediatric nephrologist, urologists and psychiatrist. Mechanisms of monosymptomatic nocturnal enuresis are mainly nocturnal polyuria, bladder overactivity and failure to awaken from sleep in response to bladder sensations. Goal oriented and etiology wise treatment includes simple behavioral intervention, conditioning alarm regimen and pharmacotherapy with desmopressin, imipramine and anticholinergic drugs. Symptoms often recurs requiring change over or combination of different modes of treatment.展开更多
Background：Blood loss after cardiac surgery can be caused by impaired platelet （PLT） function after cardiopulmonary bypass.Desmopressin or 1-deamino-8-D-arginine vasopressin （DDAVP） is a synthetic analog of vasop...Background：Blood loss after cardiac surgery can be caused by impaired platelet （PLT） function after cardiopulmonary bypass.Desmopressin or 1-deamino-8-D-arginine vasopressin （DDAVP） is a synthetic analog of vasopressin.DDAVP can increase the level of von Willebrand factor and coagulation factor Ⅷ,thus it may enhance PLT function and improve coagulation.In this study,we assessed the effects of DDAVP on PLT aggregation and blood loss in patients undergoing cardiac surgery.Methods：A total of 102 patients undergoing valvular heart surgery （from October 2010 to June 2011） were divided into DDAVP group （n =52） and control group （n =50）.A dose of DDAVP （0.3 μtg/kg） was administered to the patients intravenously when they were being rewarmed.At the same time,an equal volume of saline was given to the patients in the control group.PLT aggregation rate was measured with the AggRAM four-way PLT aggregation measurement instrument.The blood loss and transfusion,hemoglobin levels,PLT counts,and urine outputs at different time were recorded and compared.Results：The postoperative blood loss in the first 6 h was significantly reduced in DDAVP group （202 ± 119 ml vs.258 ± 143 ml,P =0.023）.The incidence of fresh frozen plasma （FFP） transfusion was decreased postoperatively in DDAVP group （3.8% vs.12%,P =0.015）.There was no significant difference in the PLT aggregation,urine volumes,red blood cell transfusions and blood loss after 24 h between two groups.Conclusions：A single dose of DDAVP can reduce the first 6 h blood loss and FFP transfusion postoperatively in patients undergoing valvular heart surgery,but has no effect on PLT aggregation.展开更多
目的采用网状meta分析方法系统性评价去氨加压素、警铃、去氨加压素联合警铃、去氨加压素联合抗胆碱能药物4种干预措施治疗儿童单症状夜遗尿的疗效。方法系统检索PubMed、Cochrance Library、EMBase和Web of Science数据库,时间截止到2...目的采用网状meta分析方法系统性评价去氨加压素、警铃、去氨加压素联合警铃、去氨加压素联合抗胆碱能药物4种干预措施治疗儿童单症状夜遗尿的疗效。方法系统检索PubMed、Cochrance Library、EMBase和Web of Science数据库,时间截止到2017年8月1日。纳入对比去氨加压素、警铃、去氨加压素联合警铃、去氨加压素联合抗胆碱能药物中任意2个或以上干预措施治疗儿童单症状夜遗尿症的随机对照试验(RCT)。按照制定好的纳入排除标准进行文献筛选,对最终纳入的RCT进行数据提取和质量评价,利用统计软件R 3.3.2和STATA 14.0完成数据分析。结果纳入15个RCT,共计1 505例患儿。网状meta分析提示,去氨加压素联合抗胆碱能药物的完全反应率和成功率高于去氨加压素(完全反应率OR=2.8,95%CI:1.5～5.4;成功率OR=3.5,95%CI:1.7～7.5)和警铃(完全反应率OR=2.7,95%CI:1.1～6.6;成功率OR=3.8,95%CI:1.6～9.0);去氨加压素联合警铃成功率高于警铃(OR=1.9,95%CI:1.1～3.4);治疗结束后警铃的复发率明显低于去氨加压素(OR=0.15,95%CI:0.03～0.53)。排序结果显示,去氨加压素联合抗胆碱能药物治疗后的完全反应率和成功率治疗效果最佳,去氨加压素联合警铃能最大程度降低每周尿床次数,警铃的复发率在4种方案中最低。结论去氨加压素联合抗胆碱能药物治疗效果明显好于单用警铃或去氨加压素;去氨加压素联合警铃方案比单用警铃或去氨加压素治疗效果略有优势或相近;去氨加压素和警铃治疗效果相近;警铃治疗的复发率最低。展开更多
文摘Nocturnal enuresis often causes considerable distress or functional impairment to patient and their parents necessitating a multidisciplinary approach from paediatrician, paediatric nephrologist, urologists and psychiatrist. Mechanisms of monosymptomatic nocturnal enuresis are mainly nocturnal polyuria, bladder overactivity and failure to awaken from sleep in response to bladder sensations. Goal oriented and etiology wise treatment includes simple behavioral intervention, conditioning alarm regimen and pharmacotherapy with desmopressin, imipramine and anticholinergic drugs. Symptoms often recurs requiring change over or combination of different modes of treatment.
文摘Background：Blood loss after cardiac surgery can be caused by impaired platelet （PLT） function after cardiopulmonary bypass.Desmopressin or 1-deamino-8-D-arginine vasopressin （DDAVP） is a synthetic analog of vasopressin.DDAVP can increase the level of von Willebrand factor and coagulation factor Ⅷ,thus it may enhance PLT function and improve coagulation.In this study,we assessed the effects of DDAVP on PLT aggregation and blood loss in patients undergoing cardiac surgery.Methods：A total of 102 patients undergoing valvular heart surgery （from October 2010 to June 2011） were divided into DDAVP group （n =52） and control group （n =50）.A dose of DDAVP （0.3 μtg/kg） was administered to the patients intravenously when they were being rewarmed.At the same time,an equal volume of saline was given to the patients in the control group.PLT aggregation rate was measured with the AggRAM four-way PLT aggregation measurement instrument.The blood loss and transfusion,hemoglobin levels,PLT counts,and urine outputs at different time were recorded and compared.Results：The postoperative blood loss in the first 6 h was significantly reduced in DDAVP group （202 ± 119 ml vs.258 ± 143 ml,P =0.023）.The incidence of fresh frozen plasma （FFP） transfusion was decreased postoperatively in DDAVP group （3.8% vs.12%,P =0.015）.There was no significant difference in the PLT aggregation,urine volumes,red blood cell transfusions and blood loss after 24 h between two groups.Conclusions：A single dose of DDAVP can reduce the first 6 h blood loss and FFP transfusion postoperatively in patients undergoing valvular heart surgery,but has no effect on PLT aggregation.
