当代医学
噹代醫學
당대의학
CHINA CONTEMPORARY MEDICINE
2015年
11期
3-4
,共2页
血液稀释%控制性降压%脑膜瘤%羟乙基淀粉%艾司洛尔
血液稀釋%控製性降壓%腦膜瘤%羥乙基澱粉%艾司洛爾
혈액희석%공제성강압%뇌막류%간을기정분%애사락이
Hemodilution%Controlled hypotension%Meningioma%Hydroxyethyl starch%Esmolol
目的：观察急性扩容血液稀释联合控制性降压对脑膜瘤手术的血液保护效果。方法择期32例美国麻醉医师协会（American Society of Anesthesiologists，ASA）I～I级脑膜瘤手术患者，随机分成对照组和试验组(n=16)。常规麻醉诱导后，试验组快速输入羟乙基淀粉20mL/kg。术中静脉用硝酸甘油和艾司洛尔实施控制性降压，维持平均动脉压（mean arterial pressure,MAP）>65mmHg。记录麻醉诱导前(T1)，血液扩容稀释后15min(T2)，手术开始后60 min(T3)及手术结束(T4)时2组患者心率（heart rate,HR）、MAP、中心静脉压（central venous pressure，CVP）、血红蛋白（hemoglobin，Hb）和血球压积（hematocrit，Hct）。结果试验组T2时MAP显著高于对照组，术中T3时MAP显著低于对照组（P<0.05）。试验组中有9例患者接受输血，出血量显著低于对照组（P<0.05）；对照组中有15例患者术中接受了异体输血，输血量显著高于试验组（P<0.05）。结论急性扩容血液稀释联合控制性降压可以安全应用于脑膜瘤手术的麻醉，减少失血量。
目的：觀察急性擴容血液稀釋聯閤控製性降壓對腦膜瘤手術的血液保護效果。方法擇期32例美國痳醉醫師協會（American Society of Anesthesiologists，ASA）I～I級腦膜瘤手術患者，隨機分成對照組和試驗組(n=16)。常規痳醉誘導後，試驗組快速輸入羥乙基澱粉20mL/kg。術中靜脈用硝痠甘油和艾司洛爾實施控製性降壓，維持平均動脈壓（mean arterial pressure,MAP）>65mmHg。記錄痳醉誘導前(T1)，血液擴容稀釋後15min(T2)，手術開始後60 min(T3)及手術結束(T4)時2組患者心率（heart rate,HR）、MAP、中心靜脈壓（central venous pressure，CVP）、血紅蛋白（hemoglobin，Hb）和血毬壓積（hematocrit，Hct）。結果試驗組T2時MAP顯著高于對照組，術中T3時MAP顯著低于對照組（P<0.05）。試驗組中有9例患者接受輸血，齣血量顯著低于對照組（P<0.05）；對照組中有15例患者術中接受瞭異體輸血，輸血量顯著高于試驗組（P<0.05）。結論急性擴容血液稀釋聯閤控製性降壓可以安全應用于腦膜瘤手術的痳醉，減少失血量。
목적：관찰급성확용혈액희석연합공제성강압대뇌막류수술적혈액보호효과。방법택기32례미국마취의사협회（American Society of Anesthesiologists，ASA）I～I급뇌막류수술환자，수궤분성대조조화시험조(n=16)。상규마취유도후，시험조쾌속수입간을기정분20mL/kg。술중정맥용초산감유화애사락이실시공제성강압，유지평균동맥압（mean arterial pressure,MAP）>65mmHg。기록마취유도전(T1)，혈액확용희석후15min(T2)，수술개시후60 min(T3)급수술결속(T4)시2조환자심솔（heart rate,HR）、MAP、중심정맥압（central venous pressure，CVP）、혈홍단백（hemoglobin，Hb）화혈구압적（hematocrit，Hct）。결과시험조T2시MAP현저고우대조조，술중T3시MAP현저저우대조조（P<0.05）。시험조중유9례환자접수수혈，출혈량현저저우대조조（P<0.05）；대조조중유15례환자술중접수료이체수혈，수혈량현저고우시험조（P<0.05）。결론급성확용혈액희석연합공제성강압가이안전응용우뇌막류수술적마취，감소실혈량。
Objective To observe the effects of acute hypervolemic hemodilution combined controlled hypotension on blood conservation in meningioma operation.Methods 32 patients(American Society of Anesthesiologists, ASA)Ⅰ-Ⅱ scheduled for meningioma operation were randomly divided into the ecperimental group and the control group(n=16). After routine induction, 20 mL/kg of hydroxyethyl starch was quickly entered through vein in the experimental group. Nitroglycerin and esmolol were used to controlled hypotension, maintaining the mean arterial pressure (MAP) > 65 mmHg. HR, MAP, CVP, Hb and Hct were monitored and recorded at the time points of pre-induction (T1), 15 min after hemodilution (T2), surgery after the start of 60 min (T3) and end (T4).Results Compared with the control group, values of MAP at T2 were significantly high, and was lower than that at T3(P<0.05). In the experimental group, 9 patients receive blood transfusions, and blood loss was significantly lower than that of control group(P<0.05).In the control group, 15 patients receive blood transfusions, blood transfusion amount was significantly higher than that of experimental group (P<0.05).Conclusion Acute hypervolemic hemodilution combined with controlled hypotension could be safely used in meningioma operation with less blood loss.
