回收式自体输血联合急性高容量稀释性血液回收对良性脑肿瘤患者血气、电解质和凝血功能的影响

Effect of salvaged autotransfusion combined with acute hypervolemic hemodilution on blood gas,electrolyte,and coagulation function in patients with benign brain tumor

目的探讨回收式自体输血联合急性高容量稀释性血液回收(AHH)对良性脑肿瘤患者血气、电解质和凝血功能的影响。方法选择2019年3月至2021年3月在东莞市人民医院行手术治疗的60例良性脑肿瘤患者进行研究,按照随机数表法分为观察组和对照组,各30例。对照组患者术中使用回收式自体输血,观察组患者在对照组基础上联合AHH进行输血。比较两组患者的围术期指标,麻醉诱导前(术前)、手术后10 min(术后)的静脉氧分压(PvO_(2))、静脉二氧化碳分压(PvCO_(2))、钾离子(K^(+))、钙离子(Ca^(2+))、钠离子(Na+)、活化部分凝血活酶时间(APTT)、凝血酶原时间(PT)、凝血酶时间(TT)、纤维蛋白原(FIB)的变化。结果观察组患者的自体血回输量、异体血回输量分别为(540.83±84.16)mL、(220.82±56.33)mL,明显少于对照组的(752.96±127.10)mL、(321.05±81.36)mL,差异均有统计学意义(P<0.05);术后,观察组患者的PvO_(2)为(33.65±2.62)mmHg,明显高于对照组的(31.08±2.41)mmHg,PvCO_(2)为(45.02±3.20)mmHg,明显低于对照组的(48.61±3.83)mmHg,差异均有统计学意义(P<0.05);两组患者术后K^(+)、Ca^(2+)、Na+比较差异均无统计学意义(P>0.05);术后,观察组患者的APTT、PT、TT分别为(36.28±3.37)s、(16.59±2.04)s、(18.59±1.85)s,明显短于对照组的(40.51±3.66)s、(19.87±2.13)s、(20.03±1.67)s,FIB为(1.93±0.21)g/L、明显高于对照组的(1.58±0.20)g/L,差异均有统计学意义(P<0.05)。结论回收式自体输血联合AHH对良性脑肿瘤患者血气、电解质和凝血功能的影响较小,值得推广应用。

Objective To study the effect of salvaged autotransfusion combined with acute hypervolemic hemodilution(AHH)on blood gas,electrolyte,and coagulation function in patients with benign brain tumor.Methods Sixty patients of benign brain tumor who underwent surgical treatment in Dongguan People's Hospital from March 2019 to March 2021 were selected,and they were randomly divided into an observation group and a control group,with 30 patients in each group.The patients in the control group were given salvaged autotransfusion,while those in the observation group were given AHH on the basis of treatment in the control group.The perioperative indexes,the changes of the intravenous partial pressure of oxygen(PvO_(2)),venous partial pressure of carbon dioxide(PvCO_(2)),potassium(K^(+)),calcium(Ca^(2+)),sodium(Na^(+)),activated partial thromboplastin time(APTT),prothrombin time(PT),thrombin time(TT),fibrinogen(FIB)before anesthesia induction(preoperative),10 min after surgery(postoperative)were compared between the two groups.Results The autologous blood transfusion volume and allogenic blood transfusion volume in the observation group were(540.83±84.16)mL and(220.82±56.33)mL,which were significantly lower than(752.96±127.10)mL and(321.05±81.36)mL in the control group(P<0.05).At 10 min after surgery,the PvO_(2) in the observation group was(33.65±2.62)mmHg,which was significantly higher than(31.08±2.41)mmHg in the control group;PvCO_(2) was(45.02±3.20)mmHg,which was significantly lower than(48.61±3.83)mmHg in the control group(P<0.05);there were no significant differences in K^(+),Ca^(2+),and Na^(+) between the two groups(P>0.05);the APTT,PT,and TT in the observation group were(36.28±3.37)s,(16.59±2.04)s,and(18.59±1.85)s,which were significantly shorter than(40.51±3.66)s,(19.87±2.13)s,and(20.03±1.67)s in the control group;FIB was(1.93±0.21)g/L,which was significantly higher than(1.58±0.20)g/L in the control group;the differences were statistically significant(P<0.05).Conclusion Salvaged autotransfusion combined with AHH have little effect on blood gas,electrolyte,and coagulation function in patients with benign brain tumor,which is worthy of promotion and application.