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急性高容血液稀释联合控制性降压和自体血回收在腰椎手术的应用 被引量:8

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摘要 目的观察急性高容血液稀释(AHH)联合控制性降压(CH)和自体血回收对腰椎手术患者的节约用血效果及安全性,以及对血流动力学的影响。方法 90名择期手术患者随机分成3组,A组为对照组,仅常规输入乳酸林格液;B组为AHH组,全麻诱导后手术开始前输血浆代用品万汶(羟乙基淀粉130/0.4氯化钠注射液)20 ml∕kg,速率30 ml∕min;C组为AHH联合控制性降压(CH)和自体血回收(BS)。结果 C组失血量显著低于A组,P<0.01,少于B组P<0.05,B、C组Hct、Hb在AHH后和术毕较AHH前降低P<0.05,2组PT、APTT在AHH后和术毕均长于AHH前P<0.05,而Fg低于AHH前P<0.05,但均在正常范围。C组未输入异体血,B组输异体血量平均为(604±165)ml,A组为(1 205±110)ml,3组比较差异有统计学意义,3组均无肺水肿、心衰及创面异常出血等并发症。结论 AHH联合CH和BS,可以提高节血效果和改善微循环,并明显减少术中出血量甚至避免异体输血,并且对机体的血液动力学、凝血功能、心功能均无明显影响,可安全用于腰椎手术。
出处 《中国输血杂志》 CAS CSCD 北大核心 2012年第5期455-457,共3页 Chinese Journal of Blood Transfusion
作者简介 通信作者:艾登斌(1964.6一),男,主任医师,主要从事临床麻醉和疼痛,电话:0532-82789478,Email:yw120824@163.com
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  • 1邓硕曾.麻醉需降低患者应激反应[J].临床麻醉学杂志,1997,12(1):30-30.
  • 2Zauder HL, Stehing L. DIC after intraoperative autotransfusion. Anesth Analg, 1993, 76:1175-1177.
  • 3Kalra M, Beech MJ, al-Khaffaf H, et al. Autotransfusion in aortic surgery : the Haemocell System 350 cell saver. Br J Surg, 1993, 80: 32-35.
  • 4Tawes RL, Sydorak GR, DuVall TB, et al. Avoiding coagulopathy in vascular surgery. Am J Surg, 1990, 160:212-216.
  • 5Mayer PJ, Gehlsen JA.Coagulopathies associated with major spinal surgery. Clin Ortop, 1989, 245:83-88.
  • 6Bull BS, Bull MH.The salvaged blood syndrome: a sequel to mechanochemical activition of platelet and leukocytes? Blood Cells, 1990, 16:5-23.
  • 7Mckie JS, Herzenberg JE. Coagulopathy complicating intraoperative blood salvage in a patient who had idiopathic scoliosis. J Bone Joint Surg Am,1997, 79: 1391-1394.
  • 8Horst HM, Dlugos S, Fath J J, et al. Coagulapathy and intraoperative blood salvage. J Trauma, 1992, 32:646-653.
  • 9Tawes RL Jr, Duvall TB.Is the "salvaged-cell syndrome"myth or reality? Am J Surg, 1996, 172: 172-174.
  • 10Cataldi S, Bruder N, Dufour H, et al. Intraoperative autologous blood transfusion in intracranial surgery. Neurosurgery, 1997, 40:765-772.

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  • 1孙梅杰,边雯,李慧禄,李刚.瑞芬太尼控制性降压对老年患者鼻内镜术后认知功能和脑氧代谢的影响[J].中国老年学杂志,2014,34(9):2358-2360. 被引量:8
  • 2李真,崔建修,周国斌,赵国栋.急性超容性血液稀释用于脊柱手术的临床观察[J].实用医学杂志,2005,21(14):1561-1562. 被引量:2
  • 3刘长利,刘景汉.围术期血液保护临床应用新进展[J].临床输血与检验,2007,9(1):90-94. 被引量:8
  • 4王维强,孙茜芬,马性觉.血液回收、稀释和控制性降压术中联合应用的临床观察[J].现代预防医学,2007,34(7):1368-1371. 被引量:2
  • 5WATERS J H. Overview of blood conservation [ J ]. Transfusion, 2004, 44(Suppl 12) : 1s-3s.
  • 6Fukusaki M, Nahnmra T, Miyoshi H, et al. Splanchnic perfusion during conntronlled hypotension combined with acute hypervolemic hemodilution : a comparison with combination of acute normovolem- ic hemodilution-gastric intramucosal pH study [ J . J Clin Anesth, 2000,12(6) :421-426.
  • 7Lotz K, Schmucher J. The organ specific changes after infusion therapy withhyd-zoxyethyl starch [ J. IntJ Inten Care, 1999, 15 (3) :93-101.
  • 8Tsuno NH, Nagura Y, Kawabata M, et al. The current status of autolo- gous blood transfusion in Japan - The importance of pre-deposit autolo- gous blood donation program and the needs to achieve patient blood management[J].Transfusion and apheresis science: official journal of the World Apheresis Association : official journal of the European Society for Haemapheresis, 2013, 49(3): 673-680.
  • 9Oscarsson A, Gupta A, Fredrikson M, et al. To continue or discontinue aspirin in the perioperative period:a randomized, con- trolled clinical trial [ J]. British Journal of Anaesthesia, 2010,104 (3) :305 -312.
  • 10Kennedy C, Leonard M, Devitt A,et al. Efficacy of preoperative au- tologous blood donation for elective posterior lumbar spinal surgery [J]. Spine (PhilaPa 1976) ,2011,36(26) :1736 - 1743.

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