急性等容血液稀释对血液成份及凝血功能的影响  

The effects of acute isovolemic hemodilution on patients' blood components and blood coagulation

作　　者：张素和[1] 宋德富[1] 陈石伦[1] 程明华[1] 扬少辉[1] 庄奕宏[1] 

机构地区：[1]汕头大学医学院第一附属医院麻醉科,515041

出　　处：《贵州医药》2002年第5期398-400,共3页Guizhou Medical Journal

摘　　要：目的了解急性等容血液稀释对血液成份及凝血功能的影响。方法选择 2 0例估计出血量多的大手术患者 ,随机分为急性等容血液稀释组 (简称稀释组 )和对照组 ,每组 10例。稀释组术前进行急性等容血液稀释 ,预计把Hct稀释至 30 % ,监测并比较两组血液稀释毕、术毕、术后第 1天、第 7天Hb、Hct、Plt、Alb、Pt、Aptt、Fg变化。结果稀释组稀释毕、术毕、术后第 1天、第 7天及对照组术毕、术后第 1天、第 7天Hb、Hct、Plt值均极显著低于术前值 (P <0 0 1) ;稀释组术毕、术后第 1天Hb、Hct极显著低于对照组同期值 (P <0 0 1) ,但第 7天两组则无差别 ;两组术毕、术后第 1天、第 7天Alb显著低于术前值 (P <0 0 5 ) ,但两组上述各监测值均仍在安全范围内 ;两组稀释毕及术毕、术后Pt、Aptt、Fg与术前相比无差别 (P >0 0 5 )。结论急性等容血液稀释可使患者Hb、Hct、Plt较显著下降 ,但经控制好稀释程度仍可维持在安全范围内 ,而对凝血功能影响轻微。Objective To study the effects of acute isovolemic hemodilution (AIVH) on patients' blood components and blood coagulation. Methods 20 patients undergoing major operation were divided into 2 groups randomly: AIVH group ( n =10) and control group ( n =10). AIVH with hematocrit of 30% was accomplished preoperatively by exchanging whole blood with Hemaccel. Hb, Hct, Plt, Alb, Pt, Aptt and Fg were measured and compared between both of the groups before and after the hemodilution, at the end of operation, 1d and 7d after operation. Results Hb, Hct and Plt decreased remarkably after the hemodilution in AIVH group, and which also decreased obviously at the end of operation, 1d and 7d after operation in both groups ( P <0.01); compared with control group, Hb and Hct decreased remarkably at the end of operation and 1d after operation in AIVH group, but had no significant difference 7d after operation; Compared with pre-operation, Alb decreased obviously at the end of operation, 1d and 7d after operation in both groups ( P <0.05). All the measurements mentioned above were still within normal range. Compared with pre operation, Pt, Aptt and Fg haven't change a bit at the end of and after operation. ( P >0.05). Conclusion Hb, Hct and Plt can be decreased remarkably by AIVH and still be within the normal range by controlling the hemodilution with little effect on the function of blood coagulation.

关 键 词：急性等容血液稀释 血液成分 凝血功能 临床应用 

分 类 号：R457[医药卫生—治疗学]