麻醉浅低温对老年髋关节置换术中失血量影响的临床研究  

Clinical study of the effect of mild hypothermia during anesthesia on blood loss in elderly hip arthroplasty

作　　者：王向东[1] 丑维斌[1] 刘喻[1] 

机构地区：[1]东莞市中山大学附属东华医院麻醉科,广东东莞523000

出　　处：《临床和实验医学杂志》2010年第14期1079-1080,共2页Journal of Clinical and Experimental Medicine

摘　　要：目的研究麻醉浅低温在髋关节置换术中对病人失血量的影响。方法 32例美国麻醉医师协会(ASA)Ⅰ～Ⅱ级择期行髋关节置换术患者,随机均分为保温组(A组)和低温组(B组)。A组在麻醉前及术中应用充气式保温毯维持病人核心温度正常。所有病人术前、术后均测定核心温度(T)、血小板计数(PLT)、凝血酶原时间(PT)、活化部分凝血酶时间(APTT)、纤维蛋白定量(Fbg),并对术前、术后各值进行对比,术后采用称重法计算术中失血量并对比。结果①两组患者手术前后血流动力学稳定;②A组手术前后核心温度无变化,B组术后和术前相比明显降低,有显著性差异。③B组与A组相比,PT、APTT延长有显著性差异,PLT、Fbg无差异。④B组与A组相比,失血量明显增多,有显著性差异。结论在髋关节置换术中,麻醉浅低温可影响病人的凝血功能,引起术中失血量增加。Objective To study the effects of mild hypothermia on blood loss during total hip arthroplasty.Methods Thirty-two aged paitents undergoing primary,unilateral total hip arthroplasties were randomly assigned to group A（normothermia group）and group B（mild hypothermia group）.Patients in group A were warmed with forced-air warming blanket to keep nomal core temperature before and during operaion.All patients＇ temperature,platelet（PLT）count,prothrombin time（PT）,activated partial thromboplastin time（APTT）,and fibrinogen（Fbg）were measured and their pre-and postoperative values were compared.Operative blood loss was evaluated after surgery by weighing the swabs and the content of the suction tubes after subtraction of the saline used.Results There was no significant difference in cardiovascular stability.Core temperature was lower at the end of surgery in group B than that in group A.Patients in group B showed significantly larger APTT and PT as compared with those in group A.No differences in PLT count and Fbg plasma concentrations were observed between the two groups.Blood loss during surgery was significantly larger in group B.Conclusion Mild hypothermia can influence coagulation and increase blood loss in aged paitents during total hip arthroplasty.

关 键 词：老年 浅低温 髋关节置换术 凝血 失血量 

分 类 号：R614[医药卫生—麻醉学]