急性等容稀释在腹腔镜妇科恶性肿瘤根治手术中的应用  

Application of acute normovolemic hemodilution during laparoscopic radical surgery for gynecological malignant tumor

作　　者：裴丽鹏 陈红 

机构地区：[1]解放军第二〇二医院妇产科,辽宁沈阳110003 [2]解放军第二〇二医院妇科,辽宁沈阳110003

出　　处：《中国肿瘤临床与康复》2015年第12期1456-1458,共3页Chinese Journal of Clinical Oncology and Rehabilitation

摘　　要：目的探讨急性等容稀释(ANH)在腹腔镜妇科恶性肿瘤根治手术中的效果。方法选取2012年4月至2014年4月间解放军第二〇二医院收治的行腹腔镜下妇科恶性肿瘤根治手术患者50例,采用随机数字表法分为急性等容血液稀释(ANH)组和对照组,每组各25例。ANH组患者在全身麻醉后用采血袋经静脉采血,同时经另一侧静脉输入晶体液或(和)胶体液,采集的血液在术中大出血基本控制后或手术结束前回输。对照组患者不采取特殊措施,如需要输血时从血库提取。结果两组患者在各时间点的平均动脉压、心率、血氧饱和度差异均无统计学意义(均P>0.05)。两组患者手术时间、麻醉时间、苏醒时间、拔除气管导管时间、术中出血量及术前和术后1d的血红蛋白、红细胞压积、血清肌酐浓度、血浆凝血酶原时间和血小板差异均无统计学意义(均P>0.05)。但输异体红细胞量及输血反应发生率差异均有统计学意义(均P<0.05)。结论在腹腔镜下妇科恶性肿瘤根治手术中应用ANH可以有效减少异体输血量和输血反应的发生。Objective To observe the effect of acute normovolemic hemodilution（ ANH） during the laparoscopic radical surgery for gynecological malignant tumor. Methods From April 2012 to April2014,50 patients under laparoscopic gynecologic malignancies radical surgery were randomly assigned into capacity ANH（ ANH） group and control group,25 cases in each group. The ANH group used blood bag for the venous sampling during general anesthesia. At the same time the crystal or and colloid liquid were used for intravenous infusion through the other venous pathway. After the major intraoperative hemorrhage be controlled and before the end of operation,the collectted blood were transfused. The control group didn＇t take special measures and the blood was take from the blood bank for blood transfuse only if the blood transfusion was necessary. Results Compared to the control group,the mean arterial pressure,heart rate,blood oxygen saturation of the ANH group at each time point had no significant differences（ P〉0. 05） and the operating time,anesthesia time,wake up time,pulling the endotracheal tube time,intraoperative bleeding and haemoglobin、hematocrit、creatinine、prothrombin time and platelet of postoperative day also had no significant differences（ P〈0. 05）. But the amount of allogeneic red blood cells and the cases of transfusion reaction in ANH group was significantly less than in the control group（ P〈0. 05）. Conclusion During laparoscopic radical surgery for gynecological malignant tumor,ANH can significantly relieve the amount of allogeneic red blood cells and the cases of transfusion reaction.

关 键 词：急性等容稀释 腹腔镜 生殖器肿瘤 女性 

分 类 号：R737.3[医药卫生—肿瘤]