经深静脉置管行急性等容血液稀释联合控制性降压的临床效果  

Clinical effect of acute normovolemic hemodilution combined with controlled hypotension through deep venous catheterization

作　　者：谢斌 蔡斌[1] 欧怡[2] 

机构地区：[1]四川省人民医院,四川成都610031 [2]绵竹市人民医院麻醉科,四川德阳618200

出　　处：《临床医学研究与实践》2017年第29期8-9,12,共3页Clinical Research and Practice

摘　　要：目的分析经深静脉置管行急性等容血液稀释联合控制性降压的临床效果。方法选取我院收治的59例估计术中可能出血较多并且符合采血条件的患者为研究对象,随机分为普通组(n=20)和深静脉组(n=39)。普通组患者进行普通采血,深静脉组患者进行经深静脉置管采血。比较两种采血方式的可行性,以及对患者生命体征、手术进程及中心静脉压的影响。结果深静脉组患者的采血时间、采血量、术中出血量、手术时间明显优于普通组,且术后凝血功能障碍及污染发生率明显低于普通组(P<0.05)。两组患者各时间点的心率、舒张压及中心静脉压比较,差异均无统计学意义(P>0.05)。结论经深静脉置管行急性等容血液稀释联合控制性降压具有可行性和实际可操作性,采血方便,采血质量高,污染的可能性小,对术中患者的生命体征与周围静脉影响不大,且不会对手术进程产生影响,可以在手术进行的同时采血,减少患者接受麻醉的时间。Objective To investigate the clinical effect of acute normovolemic hemodilution combined with controlled hypotension through deep venous catheterization. Methods Fifty-nine patients who estimated with more bleeding during operation and met the criteria of blood sampling were selected as the study objects, all the patients were randomly divided into general group(n=20) and deep venous group(n=39). The deep venous group was given deep venous catheterization for blood collection, and the general group received general blood collection. The feasibility, influence on the vital signs, the operation process and the central venous pressure of the patients were compared between the two blood collection methods.Results The blood collection time, blood collection volume, intraoperative blood loss and operation time of the deep venous group were better than those of the general group(P<0.05), and the incidences of coagulopathy and pollution of the deep venous group were lower than those of the general group(P<0.05). There were no significant differences in heart rates,diastolic pressure and central venous pressure between the two groups(P>0.05). Conclusion Acute normovolemic hemodilution combined with controlled hypotension through deep venous catheterization has feasibility and practical operability. It has the advantages of convenient blood collection, high blood sampling quality and little possibility of pollution, which has little influence on the peripheral vein and vital sign. Meanwhile, it has no effect on the surgical procedure, which can be taken at the same time as the operation is performed, and reduce the time of the patients undergoing anesthesia.

关 键 词：深静脉置管 急性等容血液稀释 可行性 

分 类 号：R544.1[医药卫生—心血管疾病]