摘要
本文报告24例吻合血管的游离皮瓣移植手术中应用血液稀释法的经验,术中病人生命体征平稳,术后皮瓣成活22例,失败2例。对血液稀释法在显微外科手术中的优点进行了阐述。
From Nov. 1985 to Jun. 1988, we used the hemodilution in microsurgery. Of the 24 free flaps 22 survived and 2 failed. While the 17 free flaps in the patients without hemodilution, only 14 flaps survived. We think that the advantages of hemodilution applied to microsurgery are: 1. The common advantages in the field of surgery are to reduce amount of bleeding du- ring the operation, to improve the blood perfusion to important organs, to avoid adverse blood reactions and to decrease the infectious diseases caused by the blood transfusion. 2. The outstanding advantages in microsurgery are as follows: (1) After moderate hemodilution had been performed, blood stickiness was so reduced that the resistance of blood stream was decreased. Because blood coagulation was reduced, bleeding and clotting time prolonged. The above-mentioned changes are benificial to keep blood vessels unobstructed and also to prevent the free flaps from undergoing the crisis. (2) After moderate hemodilution had been performed, the speed of blood stream and the cardiac output were both increased. which made the free flaps be in a state of 'overper- fusion'. The over-perfusion may both supply the free flaps with enough oxygen and elimi- nate metabolic products quickly, which will be beneficial for recovering of the flap shock and prevent the free flaps from occuring DIC.
