贺斯在食道癌手术前高容量血液稀释中的应用.pdfVIP

第 22 卷第 1 期(第 28 页) 2∞5 年 湖北民族学院学报·医学版 Journal of Hubei Institute for Nationalities ? Medical Edition Vol. 22 No. 1 P.28 2∞5 贺斯在食道癌手术前高容量血液稀释中的应用 杨引，张良清，刘欣，刘新 广东医学院附属医院麻醉科(广东湛江 524∞1) [摘要】目的 探讨术前高容量血液稀释(AHH)在全麻复合硬外麻醉下食道癌手术患者中应用的可行性。方法 ASAI-ll级病人 42 例，随机分为观察组(H 组)和对照组(C 组) ，均在全麻复合连续硬膜外麻醉下施行。 H 组: 于切皮前输入6%贺斯 1000 时，按 50 ml/min 输入。 C 组:输注复方氯化铀液，方法同 H 组。持续监测 MAP、 HR、 SP02 和 P町CO2 ;分别于稀释前、稀释后、术毕、术后第 1d 和第 7d 测定红细胞压积(HCT) 、凝血功能(町、A凹T、 FIB) 的变化;记录术中输血量和输液量;计算出血量。结果 术中两组病人出血量和输液量元显著性差异(PO. 05) ，输血量及输血病人数 H组明显低于 C 组(PO. 05) 0 H 组 MAP 的变化明显低于 C 组(PO. 时) ，稀释后，HR 明显降低(P0.05) ， 中心静脉压(CVP) 明显升高(PO. 01) ，但尚在正常生理范围。 H 组的 HCT在稀释后及术中 明显低于基础值及 C 组(P0.05) ，但在术毕和术后第 1d 及第 7d 两组间无显著性差异。町、APIT及盯B 于组间 比较均无显著性差异(P0.05) 。结论全麻复合硬膜外麻醉下食道癌手术病人施行 AHH 可有效维持血流动力 学平稳及提高对失血的耐受性。 [关键词]血液稀释:高容量:麻醉;手术;食道 [中图分类号]R614.21 [文献标识码]A (文章编号] 1∞8 -8164(2∞5)01 -∞28 -03 Study of Preoperative Acute Hypervolemic Hemodilutinn Infused with 6 % Hy，由oxyls臼rch in Patients Undergoing E?ophagω1 Carcinoma Radical Surgery YANG Yin ,ZHANG Liang - qing , LIU Xin ,et al. (Department 01 Anesthesiology ，?庐l四ed Hospital 01 G，ωngdong Medical College ，Z，归吻iiang 524l剧 ， ChiTUL ) AbstractObjective T 0 investigate the feasibility of preoperative acute hypervolemic hemodilu- tion (AHH) infused with 6% Hydroxyistarch in anesthesia combined general and epidural during esophageal carcinoma radical surge陀 Me由ods Fouty - two ASA 1 - n patients were random- ized into two groups: group H and group C, each consisting 21 cases. Group H were infused with 6% Hydroxyistarch (HES) 10∞ ml at a rate of 50 ml/min before skin incision. Group C were replaced with Ringers. solution 1000 ml MAP. H R. Sp02 and P ETC02 were monitored during the operation. HC丁， PT , APTT and F旧 were measured before and after preoperative hemodilu- tion. the end of operation , and 1 d. 7 d after operation. The volume of normal saline infused. the volume of blood loss and bank -blood infused were recorded. Results There were no signifi- cant differences in PT ,AP