急性等容血液稀释联合控制性降压在脊柱手术中的应用  

Application of ANH combined with CH in spinal operation

作　　者：舒运兵[1] 孙广运[1] 杨晓慧[2] 周力平[1] 姚洪林[3] 

机构地区：[1]宜宾市第一人民医院,四川宜宾644000 [2]宜宾市第三人民医院,四川宜宾644000 [3]宜宾市第二人民医院,四川宜宾644000

出　　处：《成都医学院学报》2011年第1期58-60,共3页Journal of Chengdu Medical College

基　　金：宜宾市科技局项目(项目编号:200803009)

摘　　要：目的观察急性等容血液稀释（ANH）联合控制性降压（CH）对脊柱手术患者的有效性和安全性。方法患者麻醉后经桡动脉放血500~700 mL,同时通过外周静脉输入等量的聚明胶肽注射液,切皮前用酚妥拉明CH,手术结束前25 min停CH,并回输自体血,分别观察人手术前、采血后、CH后、回输自体血前、后患者的平均动脉压（MAP）、HR、失血量等指标的变化。结果采血后的MAP、Hb、Hct、Ph、FIB有所下降,CH后与采血后相比仅有MAP的下降。回输前Hb、Hct、FIB又有所下降,回输前各项指标基本恢复正常。出血量与既往回顾病例比较明显减少。结论 ANH联合CH能显著降低失血量,达到有效地减少同种异体输血,充分完成血液保护。Objective To observe the efficacy and safety of acute non-isovolemic hemodelutionacute（ANH） combined with controlled hypotention（CH） in patients of spinal operation.Methods 500～700ml blood was released form the patients through radial artery after anesthesia.Equivalent polyegline was infused through peripheral venous simultaneously.Controlling hypotention was used with regilin before skin incision.The controlling hypotention was stopped and blood refusion was started 25 min before finishing the operation.The changes of indicators,such as MAP,HR and blood loss,before operation,after blood-letting,after CH and before blood refusion were observed.Results MAP、Hb、Hct、Ph、FIB declined after blood-letting.Only MAP declined after CH compared with post-bloodletting.Hb,Hct,FIB declined before blood refusion.All index resumed normal before blood refusion.Blood lose reduced significantly compared with previous reviewed cases.Conclusion ANH and CH can significantly decrease blood loss,reduce blood transfusion and fully complete blood conservation.

关 键 词：血液保护 血液稀释 稀释控制降压 

分 类 号：R614[医药卫生—麻醉学]