Influence of acute normvolemic hemodilution combined with controlled hypotension on allogeneic blood transfusion in surgical patients with ectopic pregnancy
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摘要: 目的:探讨急性等容性血液稀释(ANH)联合控制性降压(CH)对异位妊娠手术患者异体输血及安全性的影响。方法:选择2015-01-2016-08妇产科异位妊娠破裂伴出血性休克患者72例,按照数字列表法将患者随机分为ANH+CH组和ANH组,每组36例。ANH组行术中ANH,ANH+CH组在ANH基础上行CH。观察2组ANH前、后,手术开始后30min及术毕时的平均动脉压(MAP)、中心静脉压(CVP)、心率(HR)等。记录2组术中失血量、异体输血量及尿量。结果:与ANH组比较,ANH+CH组MAP在ANH后即刻、ANH后30min及术毕时降低(P<0.05),而HR在ANH后即刻、ANH后30min升高(P<0.05),但均在正常范围内。2组不同时间节点CVP比较差异无统计学意义(P>0.05)。ANH+CH组术中出血量和异体输血量均明显少于ANH组,差异有统计学意义(P<0.05)。结论:ANH与CH联合应用于异位妊娠手术,可维持患者血流动力学的稳定,减少异体输血,具有更有效的血液保护效应和安全性。Abstract: Objective:To explore the influence of acute normvolemic hemodilution (ANH) combined with controlled hypotension (CH) on allogeneic blood transfusion in surgery patients with ectopic pregnancy.Method:A total of 72 cases of surgical patients with ectopic pregnancy in the Fourth People's Hospital of Langfang City between January 2015 and August 2016 were enrolled in this study,and assigned to ANH+CH group and ANH group,36 cases in each group.The patients in ANH group were implemented ANH,and the patients in ANH+CH group were implemented CH on the basis of ANH.Mean arterial pressure(MAP),central venous pressure(CVP),heart rate (HR) before and after ANH,30 min after operation,end of the surgery were observed and recorded in two groups.Intraoperative blood loss,allogeneic blood transfusion volume,urine output were recorded in two groups.Result:Compared with AHH group,MAP reduced immediately after ANH,30 min after ANH,end of the surgery (P<0.05) and HR elevated immediately after ANH,30 min after ANH (P<0.05) in ANH+CH group,but in the normal range.CVP at different time nodes were no significant difference (P>0.05) in two groups.Intraoperative blood loss and allogeneic blood transfusion volume in ANH+CH group were significantly less than those in AHH group,the differences were statistically significant (P<0.05).Conclusion:ANH logeneic blood transfusion in surgical patients with ectopic pregnancy,which have more effective blood conservation effect and safety.
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[1] 刘红菊,何志斌,虞雪融.急性等容血液稀释在妇科恶性肿瘤中的应用[J].中国医学前沿杂志:电子版,2015,7(5):85-88.
[2] 倪燕,周钦海,蒋秀红,等.急性等容血液稀释在完全性前置胎盘合并胎盘植入剖宫产手术中的应用[J].临床麻醉学杂志,2014,30(6):571-573.
[3] 钟腾猛,肖进,黄俊玲.急性等容血液稀释对老年肝癌病人围手术期凝血功能的影响[J].血栓与止血学,2013,19(4):161-163.
[4] 谢平,查本俊,吴志云,等.急性等容血液稀释联合低中心静脉压对肝癌手术中血流动力学及氧代谢的影响[J].南昌大学学报(医学版),2013,53(6):29-32,41.
[5] 查本俊,吴志云,邓莎,等.急性等容血液稀释联合低中心静脉压在肝癌手术中的应用[J].临床麻醉学杂志,2013,29(1):49-52.
[6] 闭玉华,李凯,莫彩鲜.急性等容血液稀释联合控制性降压在肝脏手术中的应用[J].临床麻醉学杂志,2014,30(2):194-195.
[7] 唐纯海,吴全理.术前急性等容血液稀释联合术中自体血回收在神经外科手术中的应用[J].天津医药,2012,40(2):178-179.
[8] 刘洋,潘甜,姚博伟,等.急性等容血液稀释在脊柱外科手术中的应用研究[J].中国医刊,2013,48(80):69-71.
[9] 赵敏,王程,帅培玉,等.急性等容血液稀释采自体血回输联合控制性降压对异体输血及凝血功能的影响[J].华西医学2015,30(4):679-682.
[10] 张亮,卿恩明,马骏.6%羟乙基淀粉等容血液稀释对非体外循环冠状动脉旁路移植术患者内环境与氧代谢的影响[J].心肺血管病杂志,2016,35(1):45-48.
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