急性等容性血液稀释在颅脑肿瘤手术中的应用

Application of acute normovolemic hemodilution for intracranial tumor patients undergoing operation

[目的]探讨在颅脑肿瘤手术中实施急性等容性血液稀释的操作方法及应用。[方法]选择颅脑肿瘤手术病人12例,麻醉后用16G套管针从上肢正中静脉放血,同时按放血量的2倍～3倍补充胶体液和晶体液。连续监测血液稀释过程中呼吸、循环的稳定状况,并分别测定血液稀释前后、回输前后红细胞比容(Hct)、血红蛋白、血小板、红细胞的变化。[结果]12例病人共采血7200mL,血液稀释过程中病人心率、平均动脉压、中心静脉压、血氧饱和度无明显变化(P>0.05),稀释后Hct、血红蛋白、血小板、红细胞虽有下降,但术后恢复较快。[结论]急性等容性血液稀释用于颅脑肿瘤手术病人安全、有效,能缓解血源紧张,避免异体输血所引起的各种不良反应。

Objective： To probe into the operating methods and application of acute normovolemic hemodilution carrying out for intracranial tumor patients during operation. Methods： A total of 12 intracranial tumor patients undergoing operation were selected. They accepted bloodletting from vena mediana of upper limb with 16G trochar, at the same time colloid fluids and crystal fluids twice or three times as bloodletting volume were supplemented. The respiratory and circulating stabilization of patients during hemodilution were monitored continuously. And the changes of hematocrit （Hct）, hemoglobin, platelet, red blood cell count of patients were monitored before and after hemodilution and re- transfusion respectively. Results： All 12 cases totally collected 7 200 mL blood. And there were no significant changes in heart rate, mean arterial pressure, central venous pressure, saturation of blood oxygen of all patients （P 〉 0.05）. After hemodilution, the Hct, hemoglobin, platelet and red blood cell count of patients had lowered a little bit, however, postoperative recoveries of that were relatively fast. Conclusion. The acute normovolemic hemodilution is safe and effective for intracranial tumor patients undergoing operation. And which can rdieve the shortage of blood resource, avoid the various adverse effects caused by xenogenic blood transfusion for patients as well.