羟乙基淀粉200/0.5急性高容量血液稀释对脊柱椎间融合手术患者血流动力学的影响  

Effect of acute hypervolemic hemodilution with hydroxyethyl starch 200/0.5 on hemodynamics in patients undergoing spinal fusion surgery

作　　者：朱泽敏 周友龙 陈星 

机构地区：[1]长兴县人民医院骨科,313100

出　　处：《浙江医学》2017年第24期2270-2272,共3页Zhejiang Medical Journal

基　　金：浙江省医学会临床科研基金项目(2016ZYC-B10)

摘　　要：目的探讨全身麻醉下羟乙基淀粉200/0.5急性高容量血液稀释对骨科脊柱椎间融合手术患者血流动力学的影响。方法将120例全身麻醉下行骨科脊柱椎间融合手术患者按随机数字表法分为研究组和对照组,各60例。研究组采用羟乙基淀粉200/0.5,输注速率50ml/min进行急性高容量血液稀释,对照组进行常规输液。术中连续监测平均动脉压(MAP)、心率(HR)和中心静脉压(CVP)。分别于稀释前即刻(T0)、稀释后5min(T_1)、稀释后120min(T_2)抽取桡动脉血进行乳酸(Lac)、尿素氮(BUN)、红细胞压积(Hct)及血红蛋白(Hb)测定。结果研究组血液稀释后的MAP和CVP均比稀释前升高,并且研究组的CVP明显高于对照组(P<0.05),HR明显低于对照组(P<0.05);血液稀释后的T_1和T_2的Hct及Hb与对照组差异均无统计学意义(均P>0.05);研究组Lac、BUN与对照组差异均无统计学意义(均P>0.05)。结论全身麻醉下羟乙基淀粉200/0.5急性高容量血液稀释可以有效改善脊柱椎间融合手术患者的血流动力学的影响。Objective To investigate the effect of acute hypervolemic hemodilution with hydroxyethyl starch 200/0.5 onhemodynamics in patients undergoing spinal fusion surgery. Methods One hundred and twenty patients scheduled to undergospinal fusion surgery from December 2014 to December 2016 were randomly assigned in two groups: 60 cases received acutehypervolemic hemodilution with hydroxyethyl starch 200/0.5(50ml/min) during operation(study group) and 60 cases received routineintravenous infusion (control group). The mean arterial pressure (MAP), heart rate (HR) and central venous pressure (CVP) werecontinuously monitored. The blood lactic acid (Lac), urea nitrogen (BUN), blood cell volume meter (Hct) and hemoglobin (Hb) weredetermined immediately before hemodilution (T0), and 5min (T_1), 120 min (T_2) after hemodilution. Results The MAP and CVP afterinfusion were increased than those before infusion in study group; the CVP of study group was significantly higher and HR waslower than those of control group (both P<0.05). There were no significant differences in Hct, Hb, Lac and BUN levels at T_1 and T_2 between two groups (all P >0.05). Conclusion Hydroxyethyl starch 200/0.5 acute hypervolemic hemodilution can effectively improve hemodynamics in the patients undergoing spinal fusion surgery.

关 键 词：羟乙基淀粉200/0.5 急性高容量血液稀释 脊柱椎间融合手术 血液动力学 

分 类 号：R687.3[医药卫生—骨科学]