高血压病人围手术期血液流变性的变化

The Perioperativly Hemorheological Changes in Patients with Hypertension

目的观察麻醉期间及术后早期高血压病人血液流变性的变化。方法选择ASAⅠ～Ⅱ级、行腹部手术的高血压病人共30例,在麻醉前、麻醉后30min、术毕(麻醉苏醒时)、术后24、48、72h分别采静脉血,检测Hηb200s1、Lηb3s1、ηr、ηp、EAI、EDI、ERI等。结果与麻醉前比较,麻醉期间Hηb、Lηb、ηr、ηp、HCT、EAI、ERI均明显降低(P<0.05或P<0.01);术后24h～72h这些指标逐渐升高,至72h,Hηb、Lηb、ηr、ηp超出正常值范围,EDI在24h～48h明显降低(P<0.05)。结论高血压病人麻醉期间血液流变性有所改善;术后早期即恶化,需预防血栓性事件发生。

Objective To investigate the hemorheologic changes in patients with hypertension during perioperation. Methads We studied 30 patients with hypertension, ASA classification Ⅰ to Ⅱ, who had undergone elective abdomen operation and had no other factors influencing hemorheology. Blood samples from all patients were taken at the following points： pre-anesthesia, 30min after anesthesia, end-operation （during resuscitation）, 24h, 48h and 72h after operation. Results Compared with pre-anesthesia, blood viscosities（ ηb and ηp）, ηr, ηp, EAI and ERI were significantly declined （P 〈0.05 or P 〈0.01） during anesthesia. These parameters were ascended in the early postoperative period. The levels of Hηb, Lηb, ηr and ηp exceeded the normal range respely when 72h postoperation. Conclusion The study suggests that the hemorheology in patients with hypertension is improved during anesthesia and worsened in the early postoperative period. It is necessary to prevent the occurrence of thrombosis in the early postoperative period.