急性中度高容性血液稀释对坐位脑肿瘤手术病人血液动力学和电解质平衡的影响

The Effect of Acute Moderate Hypervolemic Hemodilution on Hemodynamics and Electrolytes in Sitting-position Neurosurjical Patients

目的 探讨应用不同液体进行急性中度高容性血液稀释对脑肿瘤坐位手术病人血液动力学和电解质平衡的影响。方法 选择坐位行脑肿瘤切除病人 2 0例 ,随机分成两组 (Ⅰ、Ⅱ ) ,Ⅰ组麻醉诱导后采用HES ,10mL/kg进行扩容 ,Ⅱ组麻醉诱导后采用乳酸林格氏液 10mL/kg进行扩容。然后均置病人坐位 ,观察病人坐位前后血液动力学、HCT和电解质平衡的改变。结果 Ⅰ组有效维持了血液动力学的平衡 ,血K+ 出现了稀释性下降 ,但仍维持在正常范围内 ;Ⅱ组扩容维持时间短 ,血K+ 未出现明显变化。结论 HES扩容能有效预防体位性低血压 ,但可引起K+

Objective To compare the change of hemodynamics and electrolyte under hypervolemic hemodilution with different solutions during cerebral cancer operation in sitting position.Methods Twenty neurosurgical patients received operation in sitting position and they were randomly allocated into two groups (Ⅰ?Ⅱ).After anesthesia,the patients were infused with HES (Ⅰ) or lactated Ringer's solution (Ⅱ),10 mL/kg in 30 min respectively .Results Group Ⅰ maintained the stable of hemodynamics K + decreased but still remained the normal range.The hemodilution of group Ⅱ was maintained shortly K + didn't change significantly.Conclusions Hypervolemic hemodilution with HES could prevent orthostatic hypotension effectively,could cause the decreace of K + after hypotension.