摘要
目的探讨急性高容血液稀释（AHH）联合低中心静脉压（LCVP）在髋关节置换术中的安全性和有效性。方法择期ASAⅠ-Ⅱ级的髋关节置换术患者41例，随机分为两组，组1为对照组（n=20），组2为试验组（H=21）。试验组使用30ml／kg的琥珀酰明胶在LCVP下进行AHH，对照组按常规麻醉管理进行。围术期持续监测平均动脉压（MAP）、心率（HR）、ECG、CVP、血氧饱和度（SpO2），分别于AHH前（T0，组1为麻醉诱导前）、AHH后1h（T1，组1为麻醉诱导后1h）、手术结束时（T2）记录血红蛋白（Hb）、血细胞比容（Hct）和动脉血乳酸（LAC）等指标，记录术中出血量、尿量、输血量。结果组内及组间比较，两组患者LAC值无统计学意义（P〉0.05）；而试验组出血量（482±122 vs 932±263）和输血量（206±105 vs 536±153）都明显低于对照组（P〈0.01），尿量（835±160 vs 565±82）明显高于对照组（P〈0.01），不输血患者明显增加（16／21 vs 8／20，P〈0.05）。结论AHH联合LCVP技术能够安全的用于髋关节置换术，并能减少术中出血和输血。
Objective To detect the safety and efficacy of the application of combining the acute hypervolemie hemedi-lufion（AHH） with low central venous pressure（LCVP） on hip replacement. Methods 41 patients who accepted hip replacement with ASA Ⅰ-Ⅱ, were randomly divided into two groups ： control group（group I, n=20） and trial group （group Ⅱ, n = 21）. The patients in trial group were received 30ml/kg succinylated gelatin injection for AHH before operation with LCVP. The patients in control group were received conventional anesthesia. Mean aortic pressure （MAP）, central venous pressure （CVP）, heart rate（HR）, EGG and SpO2 were continuously recorded during operation ; haematocrit （Hct）, hemoglobin （Hb） and blood lactate were recorded before hemodillon（TO, the time before induction of anesthesia in group I ）, at 1 hour after hemodilution （T1, the time after induction of anesthesia for 1 hour in group I）, and at the time that operation was over （T2） ; blood loss and blood transfusion were recorded during operation. Results There was no significant change in blood lactate between and within two groups （P〉0.05）. Blood loss（482±122 vs. 932±263, P〈0.01） and blood transfusion（206±105 vs. 536±153, P〈0.01） were significantly lower in group Ⅱ than in group I.And the cases which not need blood transfusion were more than the control group（16/21 vs. 8/20, P〈0.05）. There were no obviously change about the hematodynamios for the trial group. Conclusion AHH combined with LCVP can be safely used in the hip replacement, and can reduce blood loss and blood transfusion.
出处
《四川医学》
CAS
2009年第6期860-862,共3页
Sichuan Medical Journal
关键词
急性高容血液稀释
低中心静脉压
髋关节置换术
血液保护
acute hypervolemic hemodilution
low central venous pressure
hip replacement
blood protection
