急性非等容性血液稀释联合氨甲环酸对脑肿瘤手术患者循环功能和血气电解质的影响  

Effect of acute non-isovolemic hemodilution in combination with tranexamic acid on cycle function blood gas and electrolytes with brain tumor surgery

作　　者：骆喜宝[1] 朱玉民[2] 刘志贵[2] 黄志华[2] 覃祥玲[3] 翟庶文[4] 

机构地区：[1]桂林医学院第二附属医院麻醉科,541199 [2]桂林医学院附属医院麻醉科,541001 [3]桂林医学院附属医院门诊部,541001 [4]桂林医学院附属医院检验科,541001

出　　处：《实用医学杂志》2015年第19期3244-3246,共3页The Journal of Practical Medicine

基　　金：广西壮族自治区卫生厅计划课题(编号:Z2014300);广西高校科学技术研究项目(编号:KY2015LX253)

摘　　要：目的:探讨急性非等容血液稀释(ANIH)联合氨甲环酸(TA)对脑肿瘤手术患者循环功能和血气电解质的影响。方法:择期脑肿瘤患者42例,随机分成两组,每组21例,ANIH+TA组(A组)行ANIH并静注TA 10 mg/kg,ANIH组(B组)单用ANIH。记录两组麻醉诱导后ANIH前(T1)、ANIH后即刻(T2)、ANIH后1 h(T3)和自体血回输后(T4)HR、CVP、MAP和血气电解质变化情况,并比较各时点Hb和Hct改变。结果 :HR、CVP、MAP组间及组内差异无统计学意义。与T1比较,两组Hb、Hct在T2、T3、T4时显著降低(P<0.05);T4时,A组Hb、Hct大于B组(P<0.05)。两组pH、PaO2、PaCO2、BE值组间及组内比较差异无统计学意义。两组K+、Na+、Cl-、Ca2+组间及组内比较差异无统计学意义。结论:ANIH对循环功能以及血气电解质影响不大,联合TA可安全用于脑肿瘤手术,两者联合应用有一定的节血效应。Objective To investigate the effect of acute non-isovolemic hemodilution in combination with tranexamic acid on cycle function blood gas and electrolytes with brain tumor surgery. Methods Forty-two patients undergoing brain tumor were randomly divided into two groups. Patients in group A received ANIH plus tranexamie acid , while patients in group B received ANIH alone. Collected blood was transfused before the end of surgery. HR, CVP, MAP, hemoglubin, blood gas and plasma electrolytes were respectively recorded before ANIH（TI）, at 0 rain （T1） and 1 h （T2） after ANIH, and at the end of operation （%）. Results There were no significant changes in HR, CVP, MAP. At T2, T3, T4, Hb, Hot in both two groups lower than those at T1（P 〈 0.05）; at T4, Hb, Hct in group A were higher than those in group B. There were no significant changes in pH, PaO2, PaCO2, BE between the both two groups. There were no significant changes in Na＋, Cl-, Ca2＋ and K＋ between the both two groups. Conclusion ANIH has little effect on the cycle function and blood gas electrolyte. ANIH in combination with TA has a section blood effect. It can be used in the brain tumor operation with TA security.

关 键 词：急性非等容量血液稀释 氨甲环酸 脑肿瘤手术 

分 类 号：R614[医药卫生—麻醉学] R739.41[医药卫生—外科学]