术前急性高容量血液稀释与乳酸林格氏液对食管癌患者输血量的影响  

The Effect of Preoperative Acute High-volume Hemodilution and Lactate Lingo's Solution on Blood Transfusion Volume in Patients with Esophageal Cancer

作　　者：张侃[1] 李世多 李亚东[1] ZHANG Kan;LI Shiduo;LI Yadong(Yan'an People's Hospital,Yan'an,716000)

机构地区：[1]陕西省延安市人民医院,716000

出　　处：《实用癌症杂志》2020年第10期1680-1683,共4页The Practical Journal of Cancer

摘　　要：目的探讨术前急性高容量血液稀释与乳酸林格氏液对食管癌患者输血量的影响。方法选择63例食管癌患者,根据随机数字表法分为观察组(30例)及对照组(33例),观察组患者切皮前30 min以15 ml/(kg·h)速度静脉输注6%羟乙基淀粉130/0.4,对照组患者常规输入乳酸林格氏液,对比两组患者稀释前(T0)、稀释后(T1)、术毕(T2)点的血流动力学、血液指标,两组的出血量、输液量及输血量。结果两组患者的平均动脉压、心率对比无统计学意义,P>0.05;与T0点及对照组对比,观察组的中心静脉压明显升高,P<0.05;对照组T0~T2点的中心静脉压对比无统计学意义,P>0.05。两组患者的凝血活酶时间对比无统计学意义,P>0.05;与T0点及对照组相比,观察组的血小板计数明显降低、凝血酶原时间明显延长、Hct明显降低,P<0.05;对照组T0~T2的血小板计数及凝血酶原时间对比无统计学意义,P>0.05。两组患者的出血量、输液量对比无统计学意义,P>0.05,观察组的输血量明显低于对照组,P<0.05。结论食管癌患者术前急性高容量血液稀释安全可行,可有效降低患者的术中输血量。Objective To investigate the effect of preoperative high volume hemodilution and lactate lingo's solution on blood transfusion volume in patients with esophageal cancer.Methods 63 cases with esophageal cancer were divided into the observation group(30 cases)and the control group(33 cases),the observation group were given intravenous infusion of 6%hydroxyethyl starch 130/0.4 at a rate of 15 ml/(kg·h)30 minutes before skin incision,the control group were given ringer's lactate solution routinely.The hemodynamics,blood indexes,blood loss,infusion volume and blood transfusion volume before dilution(T0),after dilution(T1)and after surgery(T2)of the 2 groups were compared.Results The mean arterial pressure and heart rate of the 2 groups had no statistically significance,P>0.05.Compared with T0 and the control group,the central venous pressure in the observation group was significantly increased,P<0.05.There had no statistically significant difference in central venous pressure between T0 and T2 in the control group,P>0.05.There had no statistically significant difference in thrombin time between the 2 groups,P>0.05.Compared with T0 point and the control group,platelet count,prothrombin time and Hct in the observation group were significantly decreased,P<0.05.The platelet count and prothrombin time of T0-T2 in the control group had no statistically significance,P>0.05.There had no statistically significant difference in the amount of blood loss and transfusion between the 2 groups,P>0.05,and the amount of blood transfusion in the observation group was significantly lower than that in the control group,P<0.05.Conclusion Preoperative acute high-volume blood dilution was safe and feasible in patients with esophageal cancer,which could effectively reduce the intraoperative blood transfusion volume of patients.

关 键 词：术前急性高容量血液稀释 乳酸林格氏液 食管癌 输血量 血流动力学 

分 类 号：R735.1[医药卫生—肿瘤]