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急性高容量血液稀释对老年神经外科手术患者脑氧供需平衡及心血管功能的影响 被引量：10

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摘要 目的探讨急性高容量血液稀释(AHH)在老年神经外科手术患者中应用的可行性。方法神经外科择期手术老年病人(年龄≥65岁)30例,ASAⅠ～Ⅱ级。随机分为AHH组和对照组各15例。在常规全麻诱导后,AHH组在30 min内输注6%羟乙基淀粉(HES,200/0.5)12 ml/kg,对照组在30 min内输注复方电解质溶液3 ml/kg。分别于诱导前(TBase),诱导平稳后(T0)及输液30 min后(T30)记录中心静脉压(CVP)、心输出量指数(CI)、每搏输出量变异(SVV)及颈静脉球血氧饱和度(SjvO2),并计算外周血管阻力指数(SVRI)及脑氧摄取率(CERO2),同时记录研究过程中血管活性药物使用。结果全麻诱导后,两组患者CI均显著降低(P<0.05)。AHH后,AHH组CI与CVP(均P<0.05)显著升高,SVV(P<0.01)与SVRI(P<0.05)显著下降,且两组间差异显著(P<0.05)。SjvO2与CERO2在血液稀释前后及两组间差异不显著(P>0.05)。AHH组血管活性药物使用量显著小于对照组(P<0.01)。结论老年神经外科手术患者在全麻下用6%HES按12 ml/kg实施AHH使血流动力学状态更稳定,不干扰脑氧供需平衡,是安全可行的。
作者 王悦之 张玉 乔晖
机构地区 复旦大学附属华山医院老年病科 复旦大学附属华山医院麻醉科
出处 《中国老年学杂志》 CAS CSCD 北大核心 2012年第7期1377-1379,共3页 Chinese Journal of Gerontology
关键词 血液稀释 神经外科 血流动力学 羟乙基淀粉 脑氧供需平衡
分类号 R614.2 [医药卫生—麻醉学]
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参考文献15

  • 1Hai J,Lin Q,Deng D F. The pre-treatment effect on brain injury during restoration of normal perfusion pressure with hemodilution in a new rat model of chronic cerebral hypoperfusion[J].Neurological Research,2007,(06):583-587.
  • 2Muench E,Horn P,Bauhuf C. Effects of hypervolemia and hypertension on regional cerebral blood flow,intracranial pressure,and brain tissue oxygenation after subarachnoid hemorrhage[J].Critical Care Medicine,2007,(08):1844-51,1852.
  • 3Diringer MN,Axelrod Y. Hemodynamic manipulation in the neuro-intensive care unit:cerebral perfusion pressure therapy in head injury and hemodynamic augmentation for cerebral vasospasm[J].Current Opinion in Critical Care,2007,(02):156-162.doi:10.1097/MCC.0b013e32807f2aa5.
  • 4Hare GM,Mazer CD,Hutchison.JS. Severe hemodilutional anemia increases cerebral tissue injury following acute neurotrauma[J].Journal of Applied Physiology,2007,(03):1021-1029.doi:10.1152/japplphysiol.01315.2006.
  • 5Tango HK,Schmidt AP,Mizumoto N. Low hematocrit levels increase intracranial pressure in an animal model of cryogenic brain injury[J].Journal of Trauma-Injury Infection and Critical Care,2009,(03):720-726.doi:10.1097/TA.0b013e3181719b35.
  • 6Tian J,Lin X,Guan R. The effects of hydroxyethyl starch on lung capillary permeability in endotoxic rats and possible mechanisms[J].Anesthesia and Analgesia,2004,(03):768-774.
  • 7Chen S,Zhu X,Wang Q. The early effect of Voluven,a novel hydroxyethyl starch (130/0,4),on cerebral oxygen supply and consumption in resuscitation of rabbit with acute hemorrhagic shock[J].Journal of Trauma-Injury Infection and Critical Care,2009,(03):676-682.doi:10.1097/TA.0b013e318173e7da.
  • 8Neff TA,Doelberg M,Jungheinrich C. Repetitive large-dose infusion of the novel hydroxyethyl starch 130/0.4 in patients with severe head injury[J].Anesthesia and Analgesia,2003,(05):1453-1459.
  • 9Osman D,Ridel C,Ray P. Cardiac filling pressures are not appropriate to predict hemodynamic response to volume challenge[J].Critical Care Medicine,2007,(01):64-68.
  • 10Biais M,Bernard O,Ha JC. Abilities of pulse pressure variations and stroke volume variations to predict fluid responsiveness in prone position during scoliosis surgery[J].British Journal of Anaesthesia,2010,(04):407-413.doi:10.1093/bja/aeq031.

同被引文献51

  • 1李良,王贤裕,林彬,李承念,方凤铃,余修华,刘小郑,王万民.急性高容量血液稀释结合控制性降压对老年直肠癌根治术患者术后认知功能的影响[J].实用老年医学,2013,27(4):306-310. 被引量：3
  • 2田丹丹,孙瑞广.急性高容量血液稀释联合控制性降压对脑代谢的影响[J].河南外科学杂志,2005,11(2):12-13. 被引量：2
  • 3顾华华,梁伟民.急性高容量血液稀释在神经外科手术中的应用[J].临床麻醉学杂志,2006,22(9):705-706. 被引量：5
  • 4吴婉谊,葛荣秀.2型糖尿病肾病不同时期的胰岛素抵抗分析[J].医药前沿,2012,2(04):131-132.
  • 5Tircoveanu R, van der Linden E Hemodilution and anemia in pa- tients with cardiac disease what is the safe limit [J]. Curr Opin An- aesthesio, 2008, 21 (1): 66-70.
  • 6Biais M, Bernard O, Ha JC, et al. Abilities of pulse pressure varia- tions and stroke volume variations to predict fluid responsiveness in prone position during scoliosis surgery [J]. Br J Anaesth, 2010, 104 (4): 407-413.
  • 7Chen S, Zhu X, Wang Q, et al. The early effect of Voluven, a novel hydroxyethyl starch (130/0.4), on cerebral oxygen supply and con- sumption in resuscitation of rabbit with acute hemorrhagic shock [J]. J Trauma, 2009, 66(3): 676-682.
  • 8Harris TA, Yamakuchi M, Ferlito M,et al. MicroRNA-126 regulates endothelial expression of vascular cell adhesion molecule 1 . Proc Natl Acad Sci USA, 2008,105(5): 1516-1521.
  • 9Chen K, Popel AS. Vascular and perivascular nitric oxide release and transport: biochemical pathways of neuronal nitric oxide synthase (NOS1) and endothelial nitric oxide synthase (NOS3). Free Radic Biol Med, 2007,42(6):811-822.
  • 10Kuhnert F, Mancuso MR, Hampton J, et al. Attribution of" vascular phenotypes of the murine Egfl7 locus to the microRNA miR-126. Development,2008,135(24): 3989-3993.

引证文献10

二级引证文献37

中国老年学杂志
2012年 第7期

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