复方电解质洗涤回收红细胞对酸碱平衡和凝血功能的影响  

Effects of multiple electrolytes injection on acid-base balance,P50 and coagulation during autologous blood transfusion

作　　者：汪玉林[1] 陶国才[1] 石英[1] 张超[1] 邓玲[1] 

机构地区：[1]第三军医大学附属西南医院麻醉科

出　　处：《临床麻醉学杂志》2010年第5期379-381,共3页Journal of Clinical Anesthesiology

摘　　要：目的 观察复方电解质洗涤回收红细胞对红细胞携氧能力、酸碱平衡和凝血功能等的影响.方法 40例手术患者随机分为两组,每组20例,分别采用复方电解质注射液（A组）和复方乳酸钠（R组）回收自体血,检测血液回收前、输注完毕动脉血pH值、乳酸（Lac）、血氧饱和度50%时的氧分压（P50）、凝血酶原时间（PT）、活化部分凝血活酶时间（APTT）和纤维蛋白原（Fib）浓度.结果 自体血输注后15 min,R组pH值较输注前降低（P〈0.05）,R组Lac水平升高较A组更为显著（P〈0.05）,R组P50值明显升高（P〈0.05）.两组P50值与pH值输注前后变化有相关性（P〈0.05）.输注后15 min两组PT、APTT较输注前均延长;Fib明显降低（P〈0.05）.结论 复方电解质注射液洗涤回收红细胞有利于稳定酸碱平衡,防止血Lac水平升高,改善红细胞携氧能力,但对凝血功能的影响没有优势.Objective To evaluate the effects of multiple electrolytes injection on acid-base balance,P50 and coagulation in patients undergoing autologous blood transfusion. Methods Forty surgical patients were randomly divided into two groups with 20 cases each. Blood cells were washed with lactated Ringer＇s solutin（group R） or multiple electrolytes injection（group A）. The arterial acid- base balance, oxygen half-saturation pressure of hemogrobin （P50） and coagulation function were detected before and after autotransfusion. Results After autotransfusion, pH value decreased significantly in group R（P〈0. 05） and lactate was increased significantly more in group R than that in group A（P〈0.05）. P50 value increased significantly in group R（P〈0.05）. The change of P50 was correlated with that of pH value in two groups（P〈0. 05）. APTT and PT were prolonged and Fib concentration decreased significantly in both groups（P〈0.05）. Conclusion Salvaged autotransfusion with multiple electrolytes injection can keep the acid-base balance, prevent lactate elevation, and improve the oxygen carrying capacity of erythrocytes. However it has no superiority on coagulation.

关 键 词：复方电解质 复方乳酸钠 血液回收 P50 凝血功能 

分 类 号：R614[医药卫生—麻醉学]