琥珀酰明胶预扩容下结合监测Hb/Hct指导术中用血的效果

摘要

Objective: To evaluate the effect caused by testing Hb/Hct while succinylated gelatin is preload on guidance of blood usage. Method: 100 patients ( ASA Ⅰ -Ⅲ ) were divided into two groups randomly , Group A( n = 50 ) and Group B( n = 50 ). All of them were preload in succinylated gelatin( 10mL · kg-1· h-1 ). Tested Hb/Hct of patients of Group A three times, before anesthesia, before blood transfusion in surgery and 30 mintues after blood transfusion respectively. Decided whether or not transfuse PRBC and how much according to the above testing result. Tested Hb/Hct after surgery. In Group B, decided whether or not transfuse PRBC and how much based on the dotor' s experience. At the same time, tested Hb/Hct before blood transfusion and 30 minutes after blood transfusion respectively for comparison and analysis. Tested Hb/ Hct after sugery. Result: The patients in Group A and Group B were both found stable in hemodynamics during the period of anesthesia induction. Comparing Group A and Group B, the number of patients using PRBC was less in Group A ( p<0. 05 ) and the dose of PRBC consumed was less in Group A. And there was no significant difference among the patients transfused PRBC of two groups. Conclusion: The result suggests that testing Hb/Hct while Succinylated Gelatin is preload is of clinical significance in guiding blood usage in surgery anesthesia, so as to save blood in surgery.%目的:评估琥珀酰明胶预扩容下结合监测Hb/Hct在手术麻醉中指导用血的效果.方法:手术病人100例,ASA Ⅰ-Ⅲ级,随机分A、B两组,每组病人50例,两组病人麻醉前琥珀酰明胶10mL·kg-1·h-1预扩容.A组麻醉前测Hb/Hct、术中输血前测、输血后30min测Hb/Hct,根据Hb/Hct确定是否输浓缩红细胞(PRBC)及PRBC量,术后复查Hb/Hct.B组术中根据经验判断是否输PRBC及输入量,同时测定输血前、输血后30min Hb/Hct作比较分析,术后复查Hb/Hct.结果:A组与B组麻醉诱导期间血流动力学稳定,A组用PRBC的病例数比B组少(P<0.05),A组用PRBC量比B组少(P<0.05),两组病人输PRBC后Hb/Hct对比无差异.结论:琥珀酰明胶预扩容下结合监测Hb/Hct在手术麻醉中能很好地指导用血,可以节约术中的用血.