急性等容量血液稀释结合控制性降压用于全髋置换术的临床研究.doc

急性等容量血液稀释结合控制性降压用于全髋置换术的临床研究
文章来源: 2006-7-26 9:01:32
急性等容量血液稀释结合控制性降压用于全髋置换术的临床研究
中华麻醉学杂志 1999年第7期第19卷临床研究
作者:薛张纲缪长虹朱小平仓静蒋豪
单位:200032 上海医科大学附属中山医院麻醉科
关键词: 血液稀释;降压,控制性;麻醉,硬膜外;麻醉,全身;全髋置换术
【摘要】目的了解控制性降压结合急性等容量血液稀释在全髋置换术中对出血量和术后血红蛋白的影响。方法择期全髋置换术病人20例,随机分成对照组(组Ⅰ,n=10)和降压组(组Ⅱ,n=10)。组Ⅰ采用硬膜外阻滞,组Ⅱ在硬膜外阻滞加全麻下手术,术前进行等容量血液稀释,术中施行控制性降压。比较两组病人的出血量、输血量和术后血红蛋白。结果组Ⅱ病人术中平均出血(490±88)ml,比组Ⅰ病人(945±159)%;组Ⅰ病人术中平均输血(620±148)ml,而组Ⅱ病人则完全避免输异体血。两组病人术后均有轻度贫血,但仍在安全水平以上,且组间差异无显著性意义(P>)。结论急性等容量血液稀释结合控制性降压用于全髋置换术可明显减少术中出血量,对有指征的病人使用可避免输异体血。
Effects of deliberated bined with acute isovolemic hemodilution on patients undergoing total hip replacement
XU Zhanggang,MIAO Changhong,ZHU Xiaoping, et al.
Department of Anesthesia and ICU,Zhongshan Hospital,Shangai Medical University,Shanghai 200032
【Abstract】 Objective To study effects of deliberated bined with acute isovolemic hemodiluion on blood loss,postoperative hemoglubin of the patients undergoing total hip replacement(THR).Methods Twenty ASA grade Ⅰ to Ⅱ adult patients undergoing elective THR were randomized to two groups:control group(n=10)and hypotensive group(n=10).In the control group,patients only received epidural block with % the hypotensive group,all patients were anesthetized with epidural bined with general isovolemic hemodilution with hematocrit of 30% was plished by exchanging whole bloo