术前匀速补液对烟雾病患者血液流变学的影响

Effect of preoperative uniform rehydration on hemorheology in patients with moyamoya disease

目的探讨术前禁饮后开始静脉匀速补液对烟雾病患者血液流变学的影响.方法选取27例拟行间接颅内外血管重建术的烟雾病患者,于入院第二天取空腹血液行血液流变学检查为对照组,并在拟行手术前一天晚上开始禁饮、禁食后予以静脉匀速补液至入手术室前并再次采血行血液流变学检查为实验组;对比两组之间的全Ⅱ血低切粘度、全血中切粘度、全血高切粘度、血浆粘度、红细胞压积、红细胞聚集指数、红细胞刚性指数、红细胞变形指数.结果对照组的血液粘度指标中的全血低切粘度、红细胞压积及红细胞变形指标中的红细胞聚集指数均高于实验组,而对照组红细胞变形指标中的红细胞刚性指数、红细胞变形指数低于实验组,均有统计学差异(P<0.05).结论术前禁饮后开始静脉匀速补液能够降低烟雾病患者血液粘度并提高红细胞的变形性.

Objective To investigate the effect of intravenous uniform rehydration on hemorheology in patients with moyamoya disease after preoperative water-deprivation.Methods Twenty-seven patients with moyamoya disease who were about to undergo indirect intracranial and extravascular revascularization were enrolled in the study.Fasting blood was taken on the second clay of admission for hemorheological examination,which was considered as the control group.After fasting on the night before the operation,patients were given intravenous uniform rehydration until before entering the operating room,and blood was taken again for hemorheological examination,which was considered as the experimental group.Whole blood low-shear viscosity,whole blood medium-shear viscosity,whole blood high-sheur viscosity,plasma viscosity,hematocrit,erythrocyte aggregation index,erythrocyte rigidity index,and erythrocyte deformation index were compared between the two groups.Results The whole blood low-shear viscosity.hematocrit,and erythrocyte aggregation index were significantly higher in the control group than in the experimental group(P<0.05),while the erythrocyte rigidity index and erythrocyte deformation index were significantly lower in the control group than in the experimental group(P<0.05).Conclusions Intravenous uniform rehydration after preoperative water deprivation can reduce blood viscosity and improve erythrocyte deformability in patients with moyamoya disease.