急性等容血液稀释用于脑膜瘤手术的观察  

The observation of acute normovolemic bemodilution in patients undergoing meningionia operation

作　　者：丁叁强[1] 杨丹娜[1] 郑淦基[1] 

机构地区：[1]汕头大学医学院第一附属医院麻醉科,汕头515041

出　　处：《海南医学》2003年第10期8-10,共3页Hainan Medical Journal

摘　　要：目的 探讨急性等容血液稀释(ANHD)脑膜瘤手术中对减少输异体血量及术后Hb和Hct的影响。方法 择期脑膜瘤手术病人24例,随机分成对照组(Ⅰ组,n=12)和ANHD组(Ⅱ组,n=12),两组均采用气内全麻。Ⅱ组手术开始前进行血液稀释,比较两组病人围术期出血量、输异体血量和术后Hb、Hct变化。结果 两组病人围术期出血量接近,Ⅱ组有9例完全避免输异体血,余3例各输异体血200ml;Ⅰ组病人均输异体血,输血量400-800ml,显著多于Ⅱ组(P<0.01)。Ⅱ组术毕Hb及Hct与Ⅰ组对比下降(P<0.05),术后第1和第7天与Ⅰ组对比 无差异(P>0.05)。两组病人术中血流动力学基本稳定。结论 急性等容血液稀释可使脑膜瘤手术病人术中减少或不输异体血。Objective To investigate the effects of acute normovoleic hemodilution( ANHD)on post - operational Hb and Hct and reducing volume of heterogeneous transfusion during meningioma operation. Methods 24 cases with meningioma were randomly divided into two groups :control group(group one,n= 12)and ANHD group(group two,n= 12), all patients were anesthetized with Endotracheal intubation anesthesia. Hemodilutiom was accomplished pre - operatively in the ANHD group. Intraoperative blood loss, volume of heterogeneous blood to be transfused during operation and post - operative change of Hb and Hct were recorded and compared between the both groups. Results Blood loss in the patients of groups one was almost the same compared with group two. In the group two, heterogeneous blood transfused was avoided in 9 cases and the heterogeneous blood transfused in the other 3 cases was 200ml for each. In group one; however, every case was received heterogeneous blood 400 - 800ml, which was significantly more than that of group two( p< 0.01). Hb and Hct of patients in group two after operation were lower significantly than those of group one(p<0.05) ,but on the first and seventh day there were not different compared with group one(p>0.05). Hemodynamics of the two groups were stable. Conclusions Heterogeneous transfusion is decreased and even avoided by ANHD in patients undergoing meningioma operation.

关 键 词：急性等容血液稀释 脑膜瘤 手术治疗 异体血 围术期 血流动力学 体外循环 

分 类 号：R739.45[医药卫生—肿瘤] R977.8[医药卫生—临床医学]