血液稀释与4℃生理盐水输注加控制性降压在脑膜瘤手术中的应用

Application of hemodilution and 4 ℃ normal saline infusion with controlled hypotension to operation of meningioma

目的 探讨脑膜瘤手术中减少出血的方法。方法 脑膜瘤手术采用急性等容血液稀释与4℃生理盐水输注加三磷酸腺苷 (ATP)控制性降压。结果 16例病人术中MAP控制在 7～ 7.4kPa ,降温降压期间心电图 (ECG)、动脉血氧饱和度、血气分析无异常变化 ;体温降至 3 5～ 3 6℃ ,平均下降 (1.12±0 .3 2 )℃ ,无寒战及心律失常 ;失血量 (10 46± 3 47)ml,术中CVP及尿量均维持在正常范围。结论 急性等容血液稀释与 4℃生理盐水输注及ATP控制性降压 ,对脑膜瘤手术病人脑组织的修复及康复有着重要意义。

Objective To investigate the method of reducing hemorrhage in operation of meningioma.Methods Acute isovolumic hemodilution and 4 ℃ normal saline infusion with controlled hypotension by adenosine triphosphate(APT) were applied in the operation.Results MAP in 16 patients during operation was maintained between 7～7.4 kPa during induced hypotension and induced hypothermia;there were no abnormal changes in electrocardiogram(ECG)?arterial blood oxygen saturation and blood gasanalysis;temperature was reduced to 35～36 ℃,average reduction being (1.12±0.32)℃,without rigor and arrhythmia;blood loss was (1 046±347)ml,and VCP and urine were maintained within normal limits.Conclusion It is quite significant that to apply of acute hemodilution and 4 ℃ normal saline infusion with ATP controlled hypotension to the repair and rehabilitation of brain tissue of patients in meningioma operation.