血液稀释联合控制性降压对脊柱手术患者中心静脉血氧饱和度的影响

The effect of hemdilution combined with controlled hypotension on central venous blood saturation in spinal surgery

目的观察血液稀释联合控制性降压对脊柱手术患者中心静脉血氧饱和度（ScvO2）的影响。方法40例脊柱手术患者（ASAⅠ-Ⅱ级）随机数字表法分为血液稀释联合控制性降压组（20例）和对照组（20例），比较术中ScvO2、术后1、6、24h血乳酸水平。以及两组患者术中出血和输异体血的情况。结果两组患者术中ScvO2以及术后1、6、24h血乳酸水平的比较差异无统计学意义（P〉0．05）；术中实施血液稀释联合控制性降压后出血明显减少，输注异体血的量也相应减少。结论血液稀释联合控制性降压不会破坏全身组织的氧供需平衡状态。可安全地应用于脊柱手术患者。

Objective To investigate the effect of hemdilution combined with controlled hypotension on central venous blood saturation （ScvO2） in spinal surgery. Methods Forty patients （ASA Ⅰ-Ⅱ grade） undergoing spinal surgery were divided randomly into two groups of twenty, the hemodilution combined with controlled hypotension group and the control group. To observe separately the levels of ScvO2, the hemorrhage and allogeneic blood transfusion intraoperative, as well as the lactate at the 1st, the 6th and the 24th hour postoperative, then compared with the two groups. Results The levels of ScvO2 and the lactate at the 1st,the 6th and the 24th hour postoperative of the two groups had no significantly differences; the hemorrhage of the hemodilution combined with controlled hypotension group was obviously reduced, and the intraoperative allogeneic blood transfusion was declined accordingly. Conclusion Hemdilution combined with controlled hypotension don＇t lead to hypoxia and can be safely used in spinal surgery.