中国组织工程研究

中国组织工程研究 ›› 2010, Vol. 14 ›› Issue (48): 9074-9077.doi: 10.3969/j.issn.1673-8225.2010.48.034

• 骨与关节临床实践 clinical practice of the bone and joint • 上一篇    下一篇

全髋关节置换过程中急性等容血液稀释防止血栓的作用

曹桂茂1，张心雨1，于金贵2   

  1. 山东大学，1医学院，2齐鲁医院麻醉科，山东省济南市  250012
  • 出版日期:2010-11-26 发布日期:2010-11-26
  • 通讯作者: 于金贵，博士生导师，教授，山东大学齐鲁医院麻醉科，山东省济南市 250012 yujingui1109@yahoo.com.cn
  • 作者简介:曹桂茂★，男，山东省安丘市人，汉族，山东大学医学院在读硕士，主治医师，主要从事麻醉方面的研究。现工作单位为解放军济南军区总医院麻醉科。 zhanghm_2009@126.com

Thrombotic prevention of acute normovolumic hemodilution in patients undergoing total hip replacement

Cao Gui-mao1, Zhang Xin-yu1, Yu Jin-gui2   

  1. 1 Medical College, 2 Department of Anesthesiology, General Hospital of Qilu Hospital, Shandong University, Jinan  250012, Shandong Province, China
  • Online:2010-11-26 Published:2010-11-26
  • Contact: Yu Jin-gui, Doctoral supervisor, Professor, Department of Anesthesiology, General Hospital of Qilu Hospital, Shandong University, Jinan 250012, Shandong Province, China yujingui1109@yahoo.com.cn
  • About author:Cao Gui-mao★, Studying for master’s, degree, Attending physician, Medical College, Shandong University, Jinan 250012, Shandong Province, China zhanghm_2009@126.com

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284

被引次数

4

摘要：

背景：全髋关节置换过程中异体输血和输血引发的并发症问题越来越受到人们的重视。近年来从动物实验中了解到急性等容性血液稀释对血流动力学、凝血功能方面的影响，可减少降低血栓的发生概率。
目的：观察急性等容血液稀释对全髋关节置换患者围术期循环功能和内环境稳定的影响。
方法：将60例择期行全髋关节置换的患者随机分成两组，对照组及羟乙基淀粉130/0.4氯化钠注射液急性等容血液稀释组各30例，对照组静脉输入平衡液。术中持续监测平均动脉压、心率和中心静脉压的变化；并记录两组凝血功能、动脉血气、血常规及液体出入量。
结果与结论：血液稀释过程中，急性等容血液稀释组平均动脉压比对照组平稳；置换后6，24 h的血红蛋白含量、血细胞压积急性等容血液稀释组均高于对照组(P < 0.01)；异体输血量急性等容血液稀释组小于对照组(P < 0.01)。提示羟乙基淀粉130/0.4氯化钠注射液急性等容血液稀释能安全有效地用于全髋关节置换患者，血流动力学稳定，内环境影响小，可有效防止血栓的形成。

关键词: 急性等容血液稀释, 羟乙基淀粉130/0.4氯化钠注射液, 全髋关节置换, 假体, 血栓

Abstract:

BACKGROUND: Allogeneic transfusion and transfusion-induced complications in total joint replacement have aroused increasing attention. Recently, the influence of acute normovolumic hemodilution (ANH) on hemodynamics and coagulation function has been understood in animal experiments, which can reduce incidence of thrombosis.
OBJECTIVE: To evaluate the effect of ANH on circulatory function and homoiostasis of perioperative period in patients undergoing total hip replacement.
METHODS: A total of 60 patients undergoing elective total hip replacement randomly divided into control and ANH groups, with 30 cases in each group, respectively injected with balanced solution and Voluven. The mean blood pressure (MBP), heart rate (HR) and central venous pressure (CVP) were continuously monitored throughout the operation. The values of blood clotting, arterial blood gas and blood routine were detected in two groups.
RESULTS AND CONCLUSION: Compared with control group, MAP was more stable in ANH group. The hemoglobin and hematocrit were significantly greater in 6 and 24 hours postoperatively in ANH group compared with control group (P < 0.01). The volume of allogeneic transfusion was lower in ANH group than the control group (P < 0.01). ANH is more effective and safer in patients undergoing total hip replacement with stable hemodynamics and few effects on homoeostasis. Moreover, ANH can reduce thrombosis.

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