摘要
目的 比较7.5%高渗盐水和20%甘露醇用于幕上肿瘤切除术对机体凝血功能的影响.方法 选择神经外科择期行幕上肿瘤手术患者52例,随机分为7.5%高渗盐水组（HS组）和20%甘露醇组（M组）,每组26例.手术过程中,打开硬脑膜15 min前HS组开始输注7.5%高渗盐水2.5 ml/kg,M组开始输注20%甘露醇2.5 ml/kg,15~20 min输注完毕.记录输注前即刻（T0）、输注完毕后30 min（T1）、输注完毕后60 min（T2）各项观察指标.①血检弹力图（TEG）指标：反应时间（R）、凝血时间（K）、凝血形成速率（α）、血栓最大幅度（MA）、综合凝血指数（CI）;②凝血功能监测（CCT）指标：凝血酶原时间（PT）、活化部分凝血活酶时间（APTT）、纤维蛋白原（Fib）;③部分血气分析指标：Na＋浓度、K＋浓度、血红蛋白含量（Hb）、血细胞比容（Hct）;④液体出入量等：记录高渗溶液输注完毕后60 min输液量、出血量和尿量.结果 与M组相比,HS组T1时R值、α角、APTT、Na＋浓度较高,K值、Fib、Hct较低;T2时α角、Na＋浓度较高,K值、Fib、Hb、Hct较低.结论 与20%甘露醇相比,7.5%高渗盐水用于幕上肿瘤切除术对机体凝血功能影响更小.
Objective To compare the effects of 7.5% hypertonic saline and 20% mannitol on coagulation during supratentorial tumor resection.Methods A total of 52 patients who were scheduled to receive supratentoraial tumor resection were divided into two groups： a 7.5% hypertonic saline group （HS） and 20% mannitol group （M） （n=26）.Patients in each group were infused with 2.5 ml/kg of either 7.5% hypertonic saline or 20% mannitol for intraoperative brain relaxation before craniotomy.The following indexes were recorded before infusion （T0）,and 30 min （T1） and 60 min （T2） after infusion： TEG indexes （R,K,α,MA,CI）,CCT indexes （PT,APTT,Fib,Hb,Hct） and electrolytes （Na＋,K＋,Hb,Hct） and fluid intake and outtake volumes.The amounts of intravenous infusion,urinary output and bleeding were recorded.Results Compared with Group M,Group HS showed increases in R,α angle,APTT and the concentration of Na＋,but decreases in K,Fib and Hct at T1,as well as increases in α angle and the concentration of Na＋ but decreases in K,Fib,Hb and Hct at T2.Conclusions Compared with 20% mannitol,7.5% hypertonic saline produces smaller effects on coagulation during supratentorial tumor resection.
出处
《徐州医科大学学报》
CAS
2017年第7期439-442,共4页
Journal of Xuzhou Medical University
