急性非等容量血液稀释联合氨甲环酸对凝血因子和失血量的影响

Influence of acute non-isovolemic hemodilution plus tranexamic acid on coagulation factors and hemorrhage

目的:探讨在脑肿瘤手术中急性非等容量血液稀释(CANIH)联合氨甲环酸应用对凝血因子和失血量的影响。方法:择期全麻脑肿瘤手术患者42例,分为N组和T组,每组21例。N组只进行ANIH,T组采用ANIH和氨甲环酸联合应用。记录术中失血量、输血量、输液量和尿量,记录术前1 d和术后1 d凝血功能指标以及D-二聚体的变化,记录分析ANIH前、ANIH后和自体血回输后血红蛋白的变化。结果:T组失血量较N组少,自体血回输后,T组血红蛋白高于N组。T组和N组尿量和输血量无明显差异。两组对凝血因子影响不大。结论:ANIH联合氨甲环酸可以产生协同节血效果,对凝血功能影响不大,可以安全用于脑肿瘤手术。

Objective To study the effect of acute non-isovolemic hemodilution （ANIH） plus tranexamic acid on bleeding and coagulation factors. Methods Forty-two patients with brain tumor under general anesthesia were randomly divided into group N and group T with 21 patients in each group. Group N was given ANIH, while group T was given tranexamie acid and ANIH. Bleeding, transfusion, urine volume were recorded. Coagulation factors and D-dimer were detected one day before and after surgery. Hemoglobin was recorded before and after ANIH and after auto-blood was transfused. Results There was less bleeding in group T. Hemoglobin in group T was higher after transfusion. No significant difference was found in Group T and group N in terms of urine volume and transfusion rate. Both the two-groups had no difference on variation of coagulation factors. Conclusion ANIH with tranexamie acid has no significant effect on coagulation but produces synergetic effect on decreasing bleeding. The3r can be applied in surge~ of brain tumor safely.