摘要
目的探讨急性高容量血液稀释(AHH)联合异氟醚控制性降压(IDH)对血流动力学和血气的影响。方法选择20例静吸复合全麻下行脑肿瘤手术患者随机分A、B两组,每组10例。A组用6%羟乙基淀粉AHH联合IDH(维持MAP于55～65mmHg);B组单用IDH。分别于降压即刻(T1)、降压结束时(T2)、术毕(T3)。记录MAP、CVP、HR、SpO2、Hb、Hct、PaO2及电解质变化。结果与AHH前比较,A组AHH后Hb、Hct明显降低,CVP、PaO2显著升高(P<0.01)。T2时B组的Hb、Hct较T1时降低(P<0.05)。T2时两组Na+较T1时均升高,A组升高较B组明显(P<0.05或P<0.01),但均在正常范围内。结论用6%羟乙基淀粉行AHH,对颅脑肿瘤患者的血流动力学无明显不良影响;但可引起CVP及血钠升高。AHH联合IDH可改善组织供氧。
Objective To study the effects of acute hyperolemic hemodilution （AHH）combined with isoflurane deliberate hypotension （IDH） on hemodynamics and blood gas. Methods Twenty patients undergoing intracranial tumor surgery were randomly divided into two groups with 10 cases each. Group A was given AHH plus IDH（keeping MAP 55-65 mm Hg） and group B was given IDH alone. HR,SpO2 ,PETCO2, Hb, Hct, end expiration MAC of isoflurane and electrolytes were recorded before（T1 ）, at the end of IDH（T2）, and at the end of operation （T3）. Results Compared to those before AHH, Hb and Hct in group A were decreased and CVP and PaO2 were increased significantly （P〈0.01）. Hb and Hct in group B were lower at T2 than those at T1 （P〈0. 05 or P〈0.01）. Na^＋of both groups was increased after AHH compared with that at T1 ,which was more in group A than that in group B（P〈0.05 or P〈0.01） but still within normal range. Conclusion AHH with 6% hydroxyethyl starch has no adverse effect on hemodynamics, but increases CVP in patients undergoing intracranial tumor surgery. AHH combined with IDH may improve oxygen supply.
出处
《临床麻醉学杂志》
CAS
CSCD
北大核心
2009年第10期871-873,共3页
Journal of Clinical Anesthesiology
关键词
血液稀释
控制性降压
颅脑手术
Hemodilution
Deliberate hypotension
Intracranial surgery
