超容性血液稀释对老年手术患者血气与血流动力学的影响  

Influence of Hypervolemic Hemodilution on Arterial Blood Gas and Hemodynamics of Aged Patients

作　　者：李振花[1] 李苏女[1] 李文媚[1] 尹群芳[1] 

机构地区：[1]东莞市人民医院手术室,广东东莞523018

出　　处：《护理学杂志》2009年第10期54-55,共2页

基　　金：广东省东莞市科技计划项目(医疗卫生类)(B200416)

摘　　要：目的探讨超容性血液稀释在老年人外科手术中应用的可行性。方法将40例择期采用硬膜外阻滞麻醉行上腹部手术老年患者随机分为观察组和对照组各20例。麻醉前30min建立静脉通路,观察组输入6%羟乙基淀粉溶液15ml/(kg.h),1h后改为乳酸林格氏液5～8ml/(kg.h)至手术结束;对照组仅输入乳酸林格氏液5～8ml/(kg.h)至手术结束。结果对照组硬膜外注药20min后MAP、CVP开始降低,显著低于观察组(均P<0.05)。两组动脉血气值在不同观察点无显著变化(均P>0.05)。结论6%羟乙基淀粉溶液术前超容性血液稀释用于无心肺疾患的老年患者安全可行,可预防硬膜外阻滞麻醉所致的低血压,有利于保持血流动力学平稳。Objective To investigate the feasibility of hypervolemic hemodilution used in old people. Methods Totally, 40 old patients undergoing epidural anesthesia for abdominal surgery were randomly divided into an observation group and a control group equally. Patients in the control group were infused with lactate Ringer＇s solution, with the rate being 5-8 ml/（kg · h） ; while their counterparts in the observation group were given 6% hydroxyethylstarch solution for 1 h, with the rate being 15 ml/（kg ·h）, then infused with lactate Ringer＇s solution at the same rate as the control group. Results In the control group, 20 min after epidural anesthesia, MAP, CVP decreased and were significantly lower than those in the observation group（P〈0.05 for both） ; the values of arterial blood gas did not change significantly at different observation time in both groups （P〈0.05 for all）. Conclusion Application of 6 % hydroxyethylstarch solution for preoperative hypervolemic hemodilution in aged patients without cardiopulmonary disorders is feasible and safe. It can prevent epidural anesthesia-induced hypotension, and maintain stable hemodynamics.

关 键 词：6%羟乙基淀粉 硬膜外阻滞麻醉 老年人 超容性血液稀释 血气分析 血流动力学 

分 类 号：R472.3[医药卫生—护理学]