乳腺癌患者术中急性扩容性血液稀释的价值研究  

Study on the value of acute blood deliquation by fluid expansion during operation for patients with breast carcinoma

作　　者：郝雪峰 

机构地区：[1]河南省永城市神火集团职工总医院,河南永城476600

出　　处：《现代中西医结合杂志》2008年第16期2437-2438,2445,共3页Modern Journal of Integrated Traditional Chinese and Western Medicine

摘　　要：目的探讨乳腺癌手术患者行急性扩容性血液稀释的应用价值和安全性。方法将40例乳腺癌患者随机分为H组和L组各20例,2组患者术前滴注硝酸甘油扩血管,然后H组和L组30 min内分别从中心静脉快速输入羟乙基淀粉1 000 mL和乳酸林格氏液1 000 mL,观察患者术后总尿量、失血量、补液量、硝酸甘油的用量和手术时间,比较2组患者血红蛋白(Hb)、红细胞压积(Hct)、血小板(Pt)和凝血全套及血流动力学指标等变化。结果2组患者手术总用时、总失血量、总尿量、硝酸甘油的用量差异不大(P>0.05),H组患者所需总补液量少于L组(P<0.05);H组患者扩容后10 min内血常规、凝血酶谱、血流动力学指标均无明显改变;术后H组患者PT、TT值延长(P<0.05),但未超出正常指标,其他指标差异不大。结论急性扩容性血液稀释作为替代输血的一种临时应急手段,简单可行、安全,是节约用血、血液保护的一项切实有效可行的方法。Objective It is to explore the application value and safety of acute blood deliquation by fluid expansion during operation for patients with breast carcinoma. Methods 40 cases of patients with breast carcinoma were randomly divided into group H and group L. Both the two groups had 20 cases, and they were given Nitroglycerin by intravenous drip before operation to expand blood vessel. Then group H and L were quickly given hydroxyethyl starch 1000mL and Lactated Ringer＇s Solution 1000mL respectively from central vein within 30 min. Total urine volume, loss blood volume, fluid replacement volume, dosage of Nitroglycerin after operation and operation time of the patients in two groups were observed, and the changes of Hb, Hct, Pt and indexes of blood clotting and hemodynamics were compared. Results There was no difference in total operation time, total urine volume, loss blood volume and dosage of Nitroglycerin （P 〉0.05 ）, but the total fluid replacement volume in group H was less than that in group L （P 〈 0.05 ）. Indexes of blood routine, blood clotting and hemodynamics in group H didn＇t change obviously 10 min after fluid expansion except PT and TT which increased （P 〈 0.05） within normal limit. There was no difference in other indexes. Conclusion Acute blood deliquation by fluid expansion as a temporary and urgent method to take the place of blood transfusion is simple, feasible and safe, and is a good and effective method for saving blood and protection from blood.

关 键 词：乳腺癌 术中 急性扩客性血液稀释 羟乙基淀粉 乳酸林格氏液 

分 类 号：R737.9[医药卫生—肿瘤]