急性高容量血液稀释对老年手术患者凝血及肾功能影响  

Influence of Acute Hypervolemic Hemodilution on Blood Coagulation And Renal Function in Geriatric Patients

作　　者：张卫[1] 李莉[1] 

机构地区：[1]郑州大学第一附属医院麻醉科,河南郑州450052

出　　处：《中国误诊学杂志》2005年第11期2006-2008,共3页Chinese Journal of Misdiagnostics

基　　金：河南省科技厅攻关项目(编号:496060700)

摘　　要：目的:观察围术期急性高容量血液稀释(AHH)对老年患者凝血功能、肾功能的影响。方法:30例60岁以上择期手术患者随机分为3组。A、B组分别用HES、LR液行AHH,C组不行AHH。于AHH前(T1)、AHH毕(T2)、AHH后60min(T3)、术毕(T4)及术后第1天晨(T5)测定:PT、APTT、FIB、BUN、CR及尿NAG酶。记录术中、术后出血量和输血量。结果:3组PT无明显变化(P>0.05),A组APTT在T2、T3点较T1点延长(P<0.05),3组FIB在T5点高于同组T1点(P<0.05),各凝血功能指标组间比较差异无显著性。BUN、CR各时点均在正常范围内,尿NAG酶在T3～T5点均高于T1点(P<0.05),组间比较差异无显著性。术中、术后输异体血量C组例数明显多于A、B组。(P<0.05)。结论:用6%HES行AHH对老年患者凝血功能、肾功能无明显影响,同时可减少术中、术后异体血输注。Objective：To investigate the influence of AHH on blood coagulation and renal function in geriatric patients. Methods ：Thirty patients aged〉60 yr undergoing elective surgery were randomly divided into three groups. AHH was administrated with HES or LR in group A and B. AHH was not administratedin group C. PT,APTT,FIB,BUN,CR and NAG were measured at T1（before AHH）、T2（over AHH）,T3（after AHH for sixty minutes）,T4（after operation） and Ts（in the morning of the first day after operation）. Result：APTT of group A at T2 and T3 was significantly longer than that at T1 （P〈0. 05）. There were no significant difference on FIB and APTT among groups at all time points but the FIB at T5 were significantly higher than that at T1 in three groups（P〈0. 05）. Serum concentrations of CR and BUN were normal during the study. NAG at T3-T5 were higher than that at T1 （P〈0.05）and there was no significant difference among groups. The differences on blood transfusion between three groups were singnificant （P〈0.05）. Conclusion ：Prioperative AHH with HES have no obvious harmful effect on blood coagulation,renal function and hemodynamics in geriatric patient. It can effectively reduce blood transfusion.

关 键 词：血液稀释 老年人 血液凝固 肾/生理学 

分 类 号：R614.2[医药卫生—麻醉学]