摘要
等容血液稀释最早应用于外科手术、创伤和休克,近年广用于治疗周围动脉阻塞和脑血管疾患,也引起了眼科医生的重视。Hansen 等(1985)报告19例视网膜静脉阻塞(RVO),应用等容血液稀释加全视网膜光凝治疗与仅用光凝治疗组比较,获得较好的疗效。
We have treated 24 patients(25 eyes)with retinal vein occlusionby normovolemic hemodilution.Hematocrit was reduced from average43.52% to 33.62% by repeated exchange of 400ml of whole blood fornormovolemic plasma and Dextran(MW 40000)during 10 days.Visualacuity was improved in 18/25 after hemodilution and in 24/25 follow-up two months.The basic mechanism that compensates for the fall ofoxygen capacity of the diluted blood is the rise in cardiac output,and organ blood flow,factors that result from the improved fluidityof blood at lower hematoerits.Normal tissues maintain adequateoxygenation during hemodilution through the enhanced redistributionof blood.In retinal ischemic tissues this effect is enhanced,andcauses an increase in the oxygenation of ischemic tissues.Normovol-emic hemodilution improvos the visual outcome of patients with reti-nal vein occlusion,probably mediated by enhanced retinal blood flow.There were no adverse cardiopulmonary effects or other serious com-plications in hemodiluted patients.Acute normovolemic hemodilutionseems to bl an effective clinical means for the treatment of centralretinal vein occlusion or branch retinal vein occlusion.
