急性等容血液稀释自体输血应用于老年人冠状动脉旁路移植手术的初步探讨  

Therapeutic effects of acute normovolemic hemodilution replacing autologous blood donation used in coronary artery bypass graft surgery in elderly patients

作　　者：王怀斌[1] 甄文俊[1] 欧阳小康[1] 马玉健[1] 罗文琦[1] 谭洁[1] 

机构地区：[1]卫生部北京医院心血管外科,100730

出　　处：《中华老年医学杂志》2014年第1期29-31,共3页Chinese Journal of Geriatrics

摘　　要：目的探讨将急性等容血液稀释（ANH）自体输血应用于老年人冠状动脉旁路移植（CABG）手术的可行性及效果。方法60例接受体外循环心脏停搏下单纯CABG手术的65岁及以上老年冠心病患者，其中研究组30例术中应用ANH自体输血技术，对照组30例未应用该技术。结果全部病例完全再血管化，手术过程平稳，氧供需平衡，未提示组织缺氧，未发生严重并发症及手术死亡。研究组和对照组病例在心肌保护效果、凝血功能、肝功能、肾功能、血糖、负氮平衡、术后引流量等方面的指标均无统计学差异（均P〉0．05）。病例异体输红细胞悬液研究组（0．9±0．9）U低于对照组（2．5±1_2）u（t=2．704，P〈0．01）。结论遵循适当病例选取原则情况下，ANH自体输血应用于老年人CABG手术安全可行且临床效果满意。Objective To investigate effects of-acute normovolemic hemodilution （ANH） used in coronary artery bypass graft （CABG） surgery in elderly patients. Methods 60 elderly patients （aged ≥65 years） received CABG surgery under cardiopulmonary bypass, of which 30 patients using ANH techniques and 30 patients without ANH techniques. Results All patients were revascularized completely with stable surgical procedure, no serious complications and no operative mortality were found. Oxygen supplying was balanced with demanding, without tissue hypoxia. Indicators of the myocardial protective effect, coagulation, liver function, kidney function, glucose metabolism, negative nitrogen balance, and postoperative drainage volume were not significantly different between the two groups（P〉 0.05）. Allogeneic blood transfusion volume was significantly lower in study group than in control group[（0.9±0.9）U vs. （2.5±1.2）U,t=2. 704, P〈0.01]. Conclusions The ANH technique used in CABG operation in appropriate elderly patient is feasible and safe, with satisfactory clinical results.

关 键 词：血液稀释 冠状动脉旁路移植术 非体外循环 

分 类 号：R654.2[医药卫生—外科学]