急性等容血液稀释联合控制性降压在颅脑肿瘤手术中的应用分析  

Analysis of the Application of A cute Isovolumic Hemodilution Combined with Controlled Hypotension in the Opera-tion of Craniocerebral Tumor

作　　者：李敬业 钟丽萍 李玥颖 LI Jing-ye;Zhong Li-ping;LI Yue-ying(Department of Anesthesiology,Meishou People's Hospital,Meizhou,Guangdong,514000,China)

机构地区：[1]梅州市人民医院麻醉一科,广东梅州514000

出　　处：《黑龙江医学》2021年第6期569-571,共3页Heilongjiang Medical Journal

摘　　要：目的:探究急性等容血液稀释联合控制性降压在颅脑肿瘤手术中的应用效果。方法:回顾性分析2018年3月—2019年12月在梅州市人民医院进行颅脑肿瘤手术治疗的患者68例临床资料,根据治疗措施不同分组,其中将采用控制性降压治疗的33例患者临床资料归为对照组,将采用急性等容血液稀释联合控制性降压治疗的35例患者临床资料归为观察组,比较两组相关指标、血气分析指标、并发症发生情况。结果:观察组手术时间短于对照组,失血量、异体输血量均低于对照组,差异有统计学意义(P<0.05);术后,动脉血二氧化碳分压(PaCO_(2))、动脉血氧分压(PaO_(2))、动脉氢离子浓度(pH)比较,差异无统计学意义(P>0.05);术后,两组pH、PaO_(2)低于麻醉后术前,PaCO2高于术前,但是两组术后差异无统计学意义(P>0.05);观察组并发症发生率低于对照组,差异有统计学意义(P<0.05)。结论:急性等容血液稀释联合控制性降压可减少失血量和异体输血量,缩短手术时间,降低并发症发生风险,对患者术后血气指标无明显影响,可安全用于手术。Objective:To explore the effect of acute isovolumetric hemodilution combined with controlled blood pressure reduc?tion in craniocerebral tumor surgery.Methods:The clinical data of 68 patients who underwent surgical treatment of brain tumors in the hospital from March 2018 to December 2019 were retrospectively analyzed.According to different treatment measures,the clinical data of 33 patients who were treated with controlled antihypertensive treatment were classified as the control group,the clinical data of 35 patients treated with acute isovolumetric hemodilution combined with controlled hypotension were classified as the observation group,and the related indicators,blood gas analysis indicators,and complications of the two groups were compared.Results:The operation time of the observation group was shorter than that of the control group.The blood loss and the amount of allogeneic blood transfusion were lower than those of the control group.The difference was statistically significant(P<0.05).After the operation,the arterial partial pressure of carbon dioxide(PaCO2) and arterial partial pressure of oxygen(PaO2) and arterial hydrogen ion concentration(pH) were compared,the difference was not statistically significant(P>0.05).After the operation,the pH and PaO2 of the two groups were lower than that before the operation,and PaCO2 was higher than that before the operation.The difference was not statistically significant(P>0.05).The incidence of complications in the observation group was lower than that of the control group,and the difference was statistically significant(P<0.05).Conclusion:Isovolemic hemodilution combined with controlled blood pressure reduction can reduce blood loss and allogeneic blood transfusion,shorten the operation time,reduce the risk of complications,and have no significant effect on the blood gas indicators after surgery.It can be safely used for surgery.

关 键 词：颅脑肿瘤手术 急性等容血液稀释 控制性降压 血气分析 

分 类 号：R739.41[医药卫生—肿瘤]