中度急性等容性血液稀释对凝血功能的影响  

The effect of acute moderate normovolemic hemodilution on blood coagulation

作　　者：朱倩[1] 张晔[1] 张滨[1] 田鸣[1] 

机构地区：[1]首都医科大学附属北京友谊医院麻醉科,北京市100050

出　　处：《国际麻醉学与复苏杂志》2006年第2期92-95,共4页International Journal of Anesthesiology and Resuscitation

摘　　要：Objective: To evaluate the influence of preoperative moderate acute normovolemic hemodilution (ANH) with 6% hydroxyethyl starch(HES,200/0.5) on blood coagulation.Methods: Twenty ASA Ⅰ-Ⅱ patients scheduled for elective surgery were randomly assigned to receive moderate ANH with 6% HES.After induction of general anesthesia blood was withdrawn and collected before the onset of surgical blood loss,and at the same time replaced with HES.Measurements were obtained before and 15min after hemodilution and retransfusion of autologous blood.Results: After hemodilution APTT and PT were prolonged respectively from 30.50±4.50s and 12.66±1.03s to 34.48±3.62s and 14.14±0.86s(P<0.01).After retransfusion both of them could be used to normal range(P<0.01).Activated clotting time(ACT) had no changes all the while(P>0.05).After hemodilution both Fib and CR decreased significantly(P<0.01).Both of them increases significantly after retransfusion(P<0.01).Plt after hemodilution is less than that of before hemodilution significantly(P<0.01).PF decreased significantly(P<0.01) and TP was significantly(P<0.01) prolonged after hemodilution.Plt,PF and TP were resumed to a great extent(P<0.01).Conclusions: There was influence to some extent of moderate ANH with 6% HES on the function of coagulation.And platelet function could be shielded in ANH.Objective： To evaluate the influence of preoperative moderate acute normovolemic hemodilution （ANH） with 6% hydroxyethyl starch （HES, 200/0.5） on blood coagulation, Methods： Twenty ASA Ⅰ-Ⅱ patients scheduled for elective surgery were randomly assigned to receive moderate ANH with 6% HES, After induction of general anesthesia blood was withdrawn and collected before the onset of surgical blood loss, and at the same time replaced with HES, Measurements were obtained before and 15min after hemodilution and retransfusion of autologous blood. Results： After hemodilution AFTT and PT were prolonged respectively from 30, 50 ± 4, 50s and 12.66 ± 1.03s to 34. 48 ±3.62s and 14. 14 ±0.86s （P〈0.01）. After retransfusion both of them could be used to normal range （P〈0.01）. Activated clotting time （ACT） had no changes all the while （P 〉0.05）. After hemodilution both Fib and CR decreased significantly （P〈0.01）. Both of them increases significantly after retransfusion （P 〈0.01 ）. Pit after hemodilution is less than that of before hemodilution significantly （P 〈0. 01 ）. PF decreased significantly （P〈0.01） and TP was significantly （P〈0.01） prolonged after hemodilution, Pit, PF and TP were resumed to a great extent （P 〈0.01 ）. Conclusions： There was influence to some extent of moderate ANH with 6% HES on the function of coagulation. And platelet function could be shielded in ANH.

关 键 词：急性等容性血液稀释 凝血功能 自体输血 输异体血 红细胞压积 主要步骤 血液贮存 手术结束 输血指征 

分 类 号：R614[医药卫生—麻醉学]