中国输血杂志2012，Vol.25Issue(5)：439-442,4.
急性等容血液稀释联合控制性低中心静脉压对肝叶切除术患者凝血功能和术中出血量的影响
Acute normovolemic hemodilution combined with controlled low central venous pressure on coagulation function and blood loss in patients undergoing hepatic resection
摘要
Abstract
Objective To investigate effect of acute normovolemic hemodilution(ANH) combined with controlled low central venous pressure (I￡VP) on coagulation function and blood loss in patients undergoing hepatic resection. Methods Sixty ASA Ⅰ or Ⅱ patients, aged 35 ~ 71 yr, body mass index (18 - 28) kg/m2, scheduled for hepatic resection, were randomly divided into 3 groups (n =20 each) : control group (group Ⅰ ) ,LCVP group (group Ⅱ ) and ANH combined with LCVP group (group Ⅲ). Group Ⅰ received no ANH and LCVP. In group Ⅱ, CVP was maintained at 2 ～5 craH2O until hepatic parenchymal transaction. In group Ⅲ, ANH was used after intubation,the other dealing was given the same as the group E .The blood samples were taken from internal jugular vein for determination of the index of blood coagulation function,such as prothrombin time(PT) .activated partial thromboplastin time( APTT) , thrombin time (TT) and plasma fibrinogen concentration (FIB) before anesthesia( T0 ) ,30 min(T1 ) ,60 min(T2) after hemodilution and at the end of surgery(T3). Intra-operative blood loss and blood transfusion were measured. Results Intraoperative blood loss, blood transfusion and the number of blood transfusion were greater in group I than in the other groups. Blood transfusion and the number of blood transfusion were less in group M than in group Ⅱ ( P < 0. 05). All the parameters of coagulation function in the three groups were in the normal ranges. Conclusion Moderate ANH combined with LCVP can decrease intraoperarive blood loss but does not afiect coagulation function in patients undergoing hepatic resection.关键词
血液稀释/低中心静脉压/肝叶切除/失血/凝血功能Key words
Hemodilution/ Low central venous pressure/ Hepatic resection/ Blood loss/ Coagulation function分类
医药卫生引用本文复制引用
沈华春,郭建荣,徐峰,张义伟,邵怡,苏永俊..急性等容血液稀释联合控制性低中心静脉压对肝叶切除术患者凝血功能和术中出血量的影响[J].中国输血杂志,2012,25(5):439-442,4.基金项目
宁波市科技局项目(2010C50028),宁波市医学科技基金项目(2010A01) （2010C50028）
