目的观察恶性梗阻性黄疸患者在急性高容量血液稀释(AHH)后行胆道内引流手术时凝血功能的变化,探讨AHH用于梗阻性黄疸手术的安全性和可行性,为临床合理应用代血浆提供实验依据。方法28例恶性梗阻性黄疸病人均因肿瘤不能切除而行胆道内引...目的观察恶性梗阻性黄疸患者在急性高容量血液稀释(AHH)后行胆道内引流手术时凝血功能的变化,探讨AHH用于梗阻性黄疸手术的安全性和可行性,为临床合理应用代血浆提供实验依据。方法28例恶性梗阻性黄疸病人均因肿瘤不能切除而行胆道内引流术,患者分为急性高血容量稀释组(AHH组)和对照组,每组14例。AHH组在麻醉后手术前30 m in快速输入6%贺斯(HES)15 mL/kg,使血容量增加呈高容量状态。同时测量在麻醉诱导后血液稀释前(T0)、血液稀释完毕后(T1)、手术120 m in(T2)、手术结束即刻(T3)的中心静脉压、心率、血压。两组患者于T0、T2、T3以及术后第1天(T4)由颈内静脉取血,分别用于检测血红蛋白(Hb)、红细胞压积(Hct)、血小板计数(PLT)、血浆凝血酶原时间(PT)及血浆纤维蛋白原(FIB)、活化部分凝血活酶时间(APTT)。结果与对照组相比,AHH组患者在血液稀释后循环功能稳定,血细胞比容(HCT)降低明显,但凝血功能基本维持正常。结论恶性梗阻性黄疸患者行麻醉后手术前急性高血容量稀释可明显降低血细胞比容,同时维持凝血功能的相对稳定,减少术中出血。AHH对该类患者是有效的、安全的血液保护措施。展开更多
Continuous arterovenous hemifiltration (CAVH) is an effective and safe method which can remove excess water and solute in the body for treating acute and chronic renal failure with hypervolemia and heart failure. In t...Continuous arterovenous hemifiltration (CAVH) is an effective and safe method which can remove excess water and solute in the body for treating acute and chronic renal failure with hypervolemia and heart failure. In this paper the nursing management of CAVH in 15 patients is discussed.The important points in CAVH nursing are as follows:Select hemofilter of high quality, observe closely the working condition of hemofilter and its tubes, prevent coagulation of blood in the tube, warm the back-infused blood to 30℃, monitor the dosage of heparin and control fluid intake and the diet.展开更多
文摘目的观察恶性梗阻性黄疸患者在急性高容量血液稀释(AHH)后行胆道内引流手术时凝血功能的变化,探讨AHH用于梗阻性黄疸手术的安全性和可行性,为临床合理应用代血浆提供实验依据。方法28例恶性梗阻性黄疸病人均因肿瘤不能切除而行胆道内引流术,患者分为急性高血容量稀释组(AHH组)和对照组,每组14例。AHH组在麻醉后手术前30 m in快速输入6%贺斯(HES)15 mL/kg,使血容量增加呈高容量状态。同时测量在麻醉诱导后血液稀释前(T0)、血液稀释完毕后(T1)、手术120 m in(T2)、手术结束即刻(T3)的中心静脉压、心率、血压。两组患者于T0、T2、T3以及术后第1天(T4)由颈内静脉取血,分别用于检测血红蛋白(Hb)、红细胞压积(Hct)、血小板计数(PLT)、血浆凝血酶原时间(PT)及血浆纤维蛋白原(FIB)、活化部分凝血活酶时间(APTT)。结果与对照组相比,AHH组患者在血液稀释后循环功能稳定,血细胞比容(HCT)降低明显,但凝血功能基本维持正常。结论恶性梗阻性黄疸患者行麻醉后手术前急性高血容量稀释可明显降低血细胞比容,同时维持凝血功能的相对稳定,减少术中出血。AHH对该类患者是有效的、安全的血液保护措施。
文摘Continuous arterovenous hemifiltration (CAVH) is an effective and safe method which can remove excess water and solute in the body for treating acute and chronic renal failure with hypervolemia and heart failure. In this paper the nursing management of CAVH in 15 patients is discussed.The important points in CAVH nursing are as follows:Select hemofilter of high quality, observe closely the working condition of hemofilter and its tubes, prevent coagulation of blood in the tube, warm the back-infused blood to 30℃, monitor the dosage of heparin and control fluid intake and the diet.
