急性非等容量血液稀释在脊柱手术中的应用  

Application of Acute Non-isovolemic Hemodilution for Spinal Surgery

作　　者：李卫[1,2] 刘文值[1,2] 朱月皓[1,2] 李泉霖 邓义江[1,2] 

机构地区：[1]攀枝花学院附属医院 [2]攀枝花市中西医结合医院麻醉科,四川攀枝花617000

出　　处：《华西医学》2014年第11期2063-2068,共6页West China Medical Journal

摘　　要：目的观察急性非等容量血液稀释（ANIH）在脊柱手术的应用。方法 2012年1月-2013年7月将80例按美国麻醉医师协会分级为Ⅰ~Ⅱ级、行择期脊柱手术的患者分为4组,每组20例：A组为对照组（术中补液包括术前体液丧失量、生理需要量、术中体液丢失量和出血量）,B组为急性高容量血液稀释组,C组为急性等容量血液稀释组,D组为急性非等容量血液稀释组。观察各组患者术中血流动力学变化、动脉血气等。结果 B组、D组平均动脉压较A组、C组稳定;B组、D组在扩容治疗后中心静脉压显著升高（P〈0.05）,红细胞比容显著下降（P〈0.05）;A组、B组术中输异体血,C组、D组术中未输异体血。结论 ANIH在脊柱手术中应用安全,可大大减少出血量,循环更稳定。Objective To investigate the effect of acute non-isovolemic hemodilution（ANIH） on spinal surgery. Methods From January 2012 to July 2013, 80 patients scheduled for spinal surgery were enrolled. The patients were randomized into four groups, with 20 in each group. Patients in group A were infused with Ringer’s injection and polygeline for fluid loss, physiological needs and blood loss. In group B, the patients were infused with acute hypervolemic hemodilution. In group C, patients were infused with acute nomovolemic hemodilution. In group D, patients were infused with ANIH. The hemodynamics and arterial blood gas indexes were detected in all the patients. Results The mean blood pressure in group A and C was significantly more stable than that in group B and D. The central vein pressure in group B and D was significantly higher than that in group A and C after hemodilution（P 〈 0.05）, while the hematocrit in group B and D was significantly lower than that in group A and C（P 〈 0.05）. Allogeneic blood transfusion was performed in group A and B, while it was not performed in group C and D. Conclusion ANIH can reduce the volume of blood loss during spinal surgery, and it is safe.

关 键 词：急性等容量血液稀释 急性高容量血液稀释 急性非等容血液稀释 脊柱手术 采自体血 节约用血 

分 类 号：R614[医药卫生—麻醉学]