后腹膜肿物切除术患者的血液管理  

Bloodless medical and surgical procedures for retroperitoneal neoplasm resection

作　　者：关雷[1] 于浩杰[1] 李群[3] 罗成华[2] 廖代祥[2] 高健（编辑）[1] 

机构地区：[1]首都医科大学附属北京世纪坛医院麻醉科,100038 [2]首都医科大学附属北京世纪坛医院结直肠外科,100038 [3]北京大学第三医院麻醉科,100038

出　　处：《中华医学杂志》2012年第11期752-755,共4页National Medical Journal of China

摘　　要：目的探讨后腹膜肿物切除术“无输血医疗”的管理方法。方法回顾性分析2009年9月至2010年12月首都医科大学附属北京世纪坛医院36例后腹膜肿物切除术的无输血外科医疗方案，探讨肿瘤手术无输血外科医疗的术前准备、麻醉诱导与维持、术中监测、液体管理和血管活性药物使用等方面的经验。结果术中出血量（1667±347）ml，平均异体输血使用量（142±47）ml。通过实施无输血医疗策略，术中循环维持稳定，红细胞压积由自体采血前的0．368±0．095降至手术结束前的0．252±0．032，分流率也无显著降低，绝大部分患者（91．7％）均在术后1h内停用血管活性药物并拔除气管导管，送返病房。结论升红细胞药物治疗和改良贮存式自身输血是无输血外科医疗方案的重要环节。Objective To investigate the Bloodless Medical and Surgical Procedures for retroperitoneal neoplasm resection. Methods Retrospectively analyse the Bloodless Medical and Surgical Procedures during 36 retroperitoneal neoplasm resections from Beijing Shijitan Hospital Affiliated to Capital Medical University from September 2009 to December 2010, to discuss the preoperative preparation, anesthetic induction and maintainance, intraoperative monitoring and use of vasoactive drugs related experience. Results All the patients were safe during the perioperative period, without any operative and anesthetic complication. By applying the Bloodless Medical and Surgical Procedures, the intraoperative haemodynamics maintained steady, the mean hematocrit decreased from O. 368±0. 095 before autologous blood collection to 0. 252± 0. 032 before the ends of operation. Majority of the patients （91.7 % ） stop using vasoactive drugs and extubated within 1 h after operation, and return wards. Conclution Erythrocyte-raising medicine therapy and modified preservation autologous blood transfusion are important process of Bloodless Medical and Surgical Procedures.

关 键 词：无输血外科医疗 后腹膜肿物 输血 自体 

分 类 号：R656.4[医药卫生—外科学]