急性等容量血液稀释联合控制性降压在脊柱外科手术中的应用  

Application of acute hypervolemic hemodilution combined with controlled hypotension in spinal surgery

作　　者：田山 王文治 陈海帆 

机构地区：[1]广东省汕头市中医医院,广东汕头515031

出　　处：《吉林医学》2017年第7期1238-1240,共3页Jilin Medical Journal

摘　　要：目的:探析在脊柱外科手术中控制性降压联合急性等容量血液稀释的临床应用效果。方法:选取我院收治的行控制性降压(CH)联合急性等容量血液稀释(ANH)ASAⅠ~Ⅱ级脊柱手术20例患者为研究对象,并将其作为研究组,另选取ASAⅠ~Ⅱ级脊柱手术20例患者作为对照组。观察、比较两组患者在麻醉前(T_1)和手术开始前(即血液稀释后)(T_2)、术毕(T_3)、术后第一天(T_4)以及术后第五天(T_5)的Hct(红细胞比容)与Hb(血红蛋白)的数值。结果:相比T_1时点,研究组与对照组患者组间的T_2、T_3、T_4及T_5等各时点Hct和Hb情况比较,差异有统计学意义(P<0.05);研究组患者的Hct和Hb指标在T_2时点显著低于对照组,差异有统计学意义(P<0.05)。结论:行脊柱外科手术时采取CH联合ANH治疗,既能使血压保护得到充分完成,又能使同种异体输血情况降低,使患者失血量明显下降。Objective To explore the clinical application of controlled hypotension combined with acute equal volume he-modilution in spinal surgery. Method 20 cases of controlled hypotension （CH） combined with acute equal volume hemodilution （ANH） ASA Ⅰ-Ⅱ grade spine surgery in our hospital were selected as the study materials,they were selected as study group 20 patients with ASA Ⅰ-Ⅱ grade spine surgery were selected as the control group. Hct （ hematocrit） and Hb （ hemoglobin） values of two group were compared before anesthesia （T2 ） and before the operation （after dilution of the blood） （T2） , after op-eration （T3 ） , the first postoperative day （ T4 ） , and the fifth postoperative day （ T5） . Results T l point, compared group and con-trol group patients between groups of T2 ,T3 ,T4 and T5 each point such as Hct and Hb comparison （P 〈0. 05） ;The study group of Hct and Hb in patients with index in T2 point was significantly lower than control group （P 〈0. 05）. Conclusion CH surgery combined with ANH in spinal surgery,both to make blood pressure protection is fully completed,but also to reduce the situation of allogeneic blood transfusion,so that patients with blood loss decreased significantly.

关 键 词：脊柱外科 稀释控制降压 血液稀释 血液保护 

分 类 号：R687.3[医药卫生—骨科学]