| 摘要: |
| ［摘要］ 目的 探讨骨科手术行急性等容性血液稀释自体血回输对手术患者术中及术后循环功能及凝血功能的影响。方法 22例骨科手术病人术前行挠动脉穿刺采自体血，同时于外周静脉输入2～3倍的长源雪安和平衡液，术中连续监测HR、MAP、CVP、SpO2及尿量变化，分别于采血前、后30 min，回输血前、后30 min及术后1 d和7 d监测HCT、Hb、PLT、RBC的变化。结果 手术全过程的HR、MAP、CVP、SpO2无明显变化（P>0.05），ECG未见心肌缺血表现，稀释后HCT、Hb明显降低（P<0.01），但未低于最低值（0.25）。PCT、RBC有所下降（P<0.05）；术后7 d HLT、Hb、RBC恢复较快，PLT明显升高。结论 在骨科手术中应用急性等容性血液稀释自体血回输，能保证术中及术后循环功能及凝血功能的稳定，术后凝血功能明显恢复，并能减少输异体血所至的并发症，是一种安全的有效的自体输血方法。 |
| 关键词: 等容性血液稀释 自体血 骨科 手术 |
| DOI：10.3969/j.issn.1674-3806.2010.08.31 |
| 分类号:R 457.1 |
| 基金项目: |
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| Application of acute normovolemic hemodilution in orthopedic operation |
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LIANG Chun-mei
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Operating Room, Qinzhou Second People′s Hospital, Guangxi 535000,China
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| Abstract: |
| ［Abstract］ Objective To investigate the effects of acute mormovolemic hemodilution and autologons blood transfusion on circulatory function and blood cagulatory function during and after operation in the patients undergoing orthopedic operation.Methods Before operation the autologous blood in 22 patients were collected by radial artery puncture for autotransfusion and 2～3 times of Changyuan Xue′an and balanced salt solution were infused at same time. During the operation, the changes of HR、MAP、CVP、SpO2 and urine output were monitored. Then the changes of HCT, Hb, PLT, RBC at 30 minutes before and after arterial blood sampling,at 30 minutes before and after autotransfusion, at 1 day, and 7 days after operation were monitored.Results In the course of operation, no distinct change (P>0.05) of HR, MAP, CVP, SpO2 was observed. ECG showed no performance of myocardial ischemia. After hemodilution HCT and Hb declined significantly (P<0.01), but not lower than the minimum value (0.25). PLT and RBC dropped down a little (P<0.05). Seven days after operation, HCT, Hb and RBC recovered quickly; PLT increased significantly. Conclusion Application of acute normovolemic hemodilution and autologons blood transfusion in orthopedic operation can guarantee the stabilization of circulatory function and blood coagulatory function during and after operation. After operation the blood coagilatory function recover distinctly and the complication due to heterogenous blood transfusion reduce. It is a safe and effective autotransfusion method. |
| Key words: Normovolemic hemodilution Autologous blood Orthopaedics Operation |
