摘要
目的评估急性高容量血液稀释(AHH)用于老年髋关节置换术的可行性。方法将60例ASAⅡ-Ⅲ级择期行髋关节置换术的老年患者随机分为AHH组和对照组各30例。所有患者均给予腰硬联合麻醉后,AHH组立即输注万汶10mL/kg,于30 min内输完,对照组采取传统常规的输液方法。术中监测平均动脉压(MAP)、中心静脉压(CVP)、心率(HR),分别于麻醉前、麻醉后30 min和术毕测定患者血红蛋白(Hb)、血细胞比容(Hct)、凝血酶原时间(PT)、活化部分凝血时间(APTT)、纤维蛋白原(Fib),记录术中出血量、输血输液量和尿量。结果麻醉后30 min与麻醉前相比,对照组患者MAP和CVP显著降低,HR明显加快(P〈0.05),AHH组患者Hb和Hct显著降低(P〈0.05),但MAP、CVP和HR无显著变化。对照组患者输血量显著多于AHH组。结论 AHH可安全用于髋关节置换术的老年患者,能使患者手术期间的循环功能更稳定,可以常规应用。
Objective To evaluate the feasibility of acute hypervolemic hemodilution(AHH) applied in the Elderly Patients undergoing Hip Replacement.Methods Sixty ASAⅡ-Ⅲ elderly patients scheduled for hip replacement were randomized to AHH group and control group,each group containing 30 patients.After all patients were performed combined spinal epidural anesthesia,the patients in AHH group were infused by 10 mL/kg Hydroxyethyl Starch 130/0.4 in 30 minutes.A conventionally transfusion protocol was applied to the patients in control group.All patients had continuous monitoring of HR,CVP and MAP.The volumes of blood loss,blood transfusion and transfusion,urine were recorded,Hb,Hct,PT,APTT and Fib were detected at preanesthesia,30 min after anesthesia and after operation.Results 30 min after anesthesia compared with preanesthesia,the MAP and CVP of patients were significantly decreased,the HR obviously accelerated in control group(P〈0.05),the Hb and Hct of patients were notably decreased(P〈0.05),but the MAP,CVP and HR were not significantly changed in AHH group.Conclusion For elderly patients undergoing hip replacement,AHH is safe,effective,and should be considered for routine use.
出处
《重庆医学》
CAS
CSCD
北大核心
2010年第23期3175-3177,共3页
Chongqing medicine
关键词
急性高容量血液稀释
髋关节置换
血液保护
acute hypervolemic hemodilution
hip replacement
blood conservation