急性高容性血液稀释对凝血功能及心功能的影响  

Effects of acute hypervolemic hemodilution on the coagulation and cardiac function in man

作　　者：魏福泉[1] 李军[2] 米卫东[1] 徐小智 

机构地区：[1]解放军总医院麻醉科,北京市100853 [2]海军总医院麻醉科

出　　处：《临床麻醉学杂志》2004年第3期156-158,共3页Journal of Clinical Anesthesiology

摘　　要：目的　研究急性高容性血液稀释 (AHH)对凝血功能及心功能的影响。方法　选择 6 0例ASAⅠ～Ⅱ级手术患者 ,分三组 ,每组 2 0例。麻醉后吸入异氟醚 (Ⅰ组 )、静脉泵入硝酸甘油 (Ⅱ组 )或佩尔地平 (Ⅲ组 )三种方法扩张血管的同时 ,以 5 0ml/min速度静脉输注 6 %羟乙基淀粉 (HES) ,观察血液稀释期间患者心功能和凝血功能的变化。结果　静脉输注 6 %HES 5 0 0～ 10 0 0ml,各项心功能监测指标和凝血指标均无明显变化 ,组间比较无显著性差异 ;输注量达 15 0 0ml时 ,Ⅱ组和Ⅲ组心功能各项指标较基础值上升明显 (P <0 0 5 ) ,三组各项凝血指标均较基础值下降明显 (P <0 0 5 ) ,但组间比较无显著性差异。结论　在适当扩张血管的情况下 ,一定范围内的静脉滴注 6 %HES10 0 0ml以内的AHH是安全可行的 。Objective To study the effects of acute hypervolemic hemodilution(AHH)on the coagulation and cardiac function.Method Sixty surgical patients,ASAⅠ-Ⅱ,were divided into three groups with 20 cases each.6%HES 500- 1 000 ml was infused in a rate of 50 ml/min during vasodilation with isoflurane inhalation(group Ⅰ),pumping nitroglycerin(group Ⅱ) or nicardipine(group Ⅲ).The blood coagulation function and cardiac function were observed during hemodilution.Results The cardiac function and coagulation function were not changed significantly during infusing 6% Haes 500- 1 000 ml in three groups.When the volume of infusion was over 1 500 ml,the parameters of cardiac function increased and those of coagulation decreased significantly(P<0.05)compared with the baseline in groups Ⅰ and groups Ⅲ.Conclusion AHH with 6%HES less than 1 000 ml is safety during certain range vasodilation by using above three methods,and has no marked influence on the blood coagulation.

关 键 词：急性高容性血液稀释 AHH 凝血功能 心功能 血小板 

分 类 号：R614[医药卫生—麻醉学]