急性等容血液稀释对体外循环术后凝血功能的影响  

Effects of acute normovolemic hemodilution on the coagulation function after cardiopulmonary bypass

作　　者：袁从虎[1] 张亚军[2] 钱静[1] 宋建祥[2] 于广东[1] 

机构地区：[1]盐城市第三人民医院麻醉科,224000 [2]盐城市第三人民医院心胸外科,224000

出　　处：《国际心血管病杂志》2016年第4期243-245,250,共4页International Journal of Cardiovascular Disease

基　　金：江苏省盐城市医学科技发展计划项目(YK2011104)

摘　　要：目的:探讨急性等容血液稀释(ANH)对体外循环下心脏直视手术患者凝血功能的影响。方法:选择在体外循环下行心脏直视手术的患者64例,随机分为ANH组(n=30)和非ANH组(n=34),观察两组患者手术前后凝血功能和血常规指标,并记录术中出血量及输液量。结果:与术前相比,两组患者术后凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、凝血酶时间(TT)均较术前明显延长,纤维蛋白原(FIB)、血小板计数(PLT)、血红蛋白(Hb)和红细胞压积(Hct)均较术前明显降低,但两组间PT、APTT、TT、Hb、Hct变化无统计学差异;与非ANH组相比,ANH组患者术后FIB和PLT降低更加明显(P<0.05)。两组患者术中失血量无统计学差异。结论:体外循环心脏直视手术患者应用ANH时对凝血功能影响轻微,且术中失血量无明显增加。Objective：To investigate the effects of acute normovolemic hemodilution （ANH） on the coagulation function in patients undergoing open heart surgery under cardiopulmonary bypass （CPB）. Methods：Sixty-four patients scheduled for CPB were randomly divided into two groups： ANH group （n = 30） and non-ANH group （n = 34）. The indexes of coagulation function and routine blood test were examined both before and after surgery in the two groups, and the amounts of blood loss and fluid infusion during the surgeries were recorded. Results： Compared with the results before surgery, the prothrombin time （PT）, activated partial thromboplastin time （APTT）, thrombin time （TT） were increased in both groups after surgery, whereas the fibrinogen （FIB）, platelet （PTT）, hemoglobin （Hb） and hematocrit （Hct） were decreased, but there was no significant difference in the changes of PT, APTT, TT, Hb and Het before and after surgery between the two groups. Compared with the results of the non-ANH group, the changes of FIB and PLT in ANH group were more significant（P〈0. 05）. There was no significant difference in the amount of blood loss during operation between the two groups. Conclusion： ANH has slight effects on coagulation function of patients receiving CPB, and has no effect on their blood loss.

关 键 词：急性等容血液稀释 体外循环术 凝血功能 红细胞压积 

分 类 号：R614[医药卫生—麻醉学]