摘要
目的 研究急性高容量血液稀释（AHH）联合硝酸甘油滴注对老年骨科患者氧代谢的影响.方法 选择ASAⅠ～Ⅱ级、择期行脊柱手术患者40例,随机分为2组：AHH组（A组）,对照组（C组）.2组入室后补充基础生理需要量及禁食丧失需要量.A组患者以25 ml/min速度输注6%羟乙基淀粉（15 ml/kg）行高容量血液稀释,入室至麻醉苏醒期间连续观察收缩压（SBP）、舒张压（DBP）、心率（HR）、脉搏氧饱和度（SpO2）、中心静脉压（CVP）,记录停药至苏醒时间及苏醒质量,记录患者苏醒期并发症的发生数.在AHH前、后及手术结束时分别测血细胞比容（Hct）、血气、血乳酸（Lac）.记录术中出血量及输血量.结果 2组患者在手术时间、苏醒时间、动脉血气以及Lac无明显差别,而在输血量及输血比例方面A组明显低于C组（P＜0.01）.结论 急性高容量血液稀释联合硝酸甘油滴注可安全用于老年骨科手术患者.
Objective To investigate the effect of acute hypervolemic hemodilution （AHH） combined with nitroglyc- erin instillation on the oxygen metabolism in aging patients treated in our orthopedics department. Methods 40 patients （ASA Ⅰ-Ⅲ） scheduled for spinal operation were randomized into two groups： acute hypervolemic hemodilution group （A group） and control group （C group）. The two groups were given general transfusion for the supply of basic physiologically required volume and the lost volume due to fasting since their entry into the operation theater. Patients in A group were transfused with 6% hetastarch of 15 ml/kg at the velocity of 25 ml/min for hypervolemic hemodilution. The systolic blood pressure （SBP）, diastolic blood pressure （DBP）, heart rate （HR） , pulse oximetry （SpO2 ） and central venous pressure （CVP） were continuously observed from the patients＇ entry into the theater to palinesthesia. The duration from drug withdrawal to palinesthesia and the quality of palinesthesia were recorded as well as the number of complications during the palinesthesia. The hematocrit （Hct） , blood gas indexes and blood lactic acid （Lae） were determined before and after AHH as well as at the end of operation. The volumes of intraoperative hemorrhage and blood transfusion were recorded. Results There were no significant differences in operation duration, palinesthesia time, arterial blood gas indexes and Lac, while the blood transfusion volume and cases/times were significant lower in A group than those in C group （P 〈 0.01 ）. Conclusion Acute hypervolemie hemodilution combined with nitroglycerin instillation is safely applicable in elderly patients of the orthopedics department.
出处
《徐州医学院学报》
CAS
2011年第4期219-221,共3页
Acta Academiae Medicinae Xuzhou
