高原地区自体输血及血液稀释的临床研究  

STUDY OF AUTOTRANSFUSION AND HEMODI LUTION OF PERIO-PERATION IN HIGH ALTITUDE

作　　者：王祖谦[1] 赵世军[1] 贾珍[1] 陈仲海[1] 祝建新[1] 宋晓农[1] 肖碧槐[1] 李银宏[1] 王庆玲[2] 

机构地区：[1]青海大学附属医院麻醉科 [2]青海大学附属医院检验科

出　　处：《青海医学院学报》2005年第3期204-206,213,共4页Journal of Qinghai Medical College

基　　金：青海省卫生厅指导课题;青海省科技厅科教批准登记号9632005Y0128

摘　　要：目的研究高原地区自体输血、血液稀释在围手术期应用的可行性及意义。方法选择ASAⅠ-Ⅱ级,年龄23-68岁,术前Hb≥130g/L,HCT≥0.4L/L,术中出血约在800ml以上的择期外科手术病例80例,分为两组。实验纽40例,于术前或(和)麻醉后采集自体血400-800ml,用以自体血回输,术中给予扩容行血液稀释,通过监测HCT和Hb控制输血。对照组按常规方法输血和输液。结果实验组术中输血量为(462±220)ml,比对照组(1297±640)ml减少60%,术中输血费用:实验组为46636.2元,比对照组(93379.08元)减少49.9%。术中实验组动脉血气正常,血流动力学稳定,凝血功能变化不大。结论在高海拔地区可以采用自体输血与术中扩容血液稀释相结合的方法达到节约用血的目的。Objective To study the safe and effective in autotransfusion and hemodilution in high altitude （sea level 2260m） Methods Eighty patients were randomly divided two groups, ASA Ⅰ -Ⅱ ,age ranged from 23-68ys, Hb≥ 130g/L, HCT≥0.4L/L before operation. Estimated volume of bleeding more than 800mL during operation for one case. Group A （study）,the blood was letting from vein are 400-800ml preoperation or after general Anesthesia and transferring back during surgery, also transferring Hydroxyethyl stanch and Ringer,s lactate in order to hemodilute and controlled the banked blood transfusion by examination of Hh, HCT. Group B transfusion blood by routine treated. The changes of Hb,HCT, PLT,PT,APTY,FIB,TT, arterial blood gas and Bp（SBp,MBp, DBp）Were observed for two groups in perioperation. Results The volume of transfusion blood in group A （462±220）ml decreased 60% than group B （1297±640）ml. The cost of transfusion blood in group A （46636.2 yuan） decreased 49.9% than group B（93379.08 yuan）. Conclusion So bleeding volume estimated more than that in major surgery, letting autologous blood preoperation and controlling hemodilution are safe and effective in high altitude. It can save allogeniec blood in order to reduce the risk of transfusion blood.

关 键 词：高原地区 自体输血 血液稀释 围术期 

分 类 号：P941.74[天文地球—自然地理学] R457.1[医药卫生—治疗学]