急性等容性血液稀释自体输血应用于骨科大手术时临床麻醉及血流动力学的变化分析

摘要

目的：分析急性等容性血液稀释自体输血应用于骨科大手术时临床麻醉及血流动力学的变化。方法：随机选取2014年4月-2016年4月本院收治的择期接受骨科大手术治疗的患者80例作为研究对象，依据治疗方法分为预储自体输血组（预储组）和急性等容血液稀释自体输血组（急性等容血液稀释组），每组40例。比较两组患者的血红蛋白（Hb）、红细胞压积（HCT）、心率（HR）、动脉血压（ABP）、Na+、K+、Cl-值。结果：急性等容血液稀释组患者新鲜冰冻血浆输入量和浓缩红细胞输入量均明显低于预储组，差异均有统计学意义（P<0.05）；采血后、自体血回输前后急性等容血液稀释组患者的Hb、HCT值均低于预储组，差异均有统计学意义（P<0.05）；两组患者采血前后及自体血回输前后的收缩压、舒张压、HR、Na+、K+、Cl-值比较，差异均无统计学意义（P>0.05）。结论：急性等容性血液稀释自体输血应用于骨科大手术时临床麻醉及血流动力学的变化小，安全有效。%Objective:To analyze the clinical anesthesiology and hemodynamics changes in acute equal volume blood dilution of autologous blood transfusion in the application of orthopedic surgery.Method:From April 2014 to April 2016,80 cases of elective major orthopedic surgery treatment in our hospital were selected as the research objects,they were divided into the pre storage autologous blood transfusion group(pre storage group) and acute equal volume blood dilution autologous blood transfusion group(acute blood dilution group) according to the treatment method,each group had 40 cases.Two groups of hemoglobin(Hb),hematocri(HCT),heart rate(HR),arterial blood pressure(ABP),Na+,K+,Cl-value were compared.Result:The input amount of fresh frozen plasma and the concentration of red blood cells in the acute blood dilution group were significantly lower than the pre storage group,the differences were statistically significant(P<0.05).Hb and HCT values in the acute blood dilution group were lower than pre storage group after blood collection,before and after autologous blood transfusion,the differences were statistically significant(P<0.05).The systolic blood pressure,diastolic blood pressure,HR,Na+,K+ and Cl- values were not statistically significant of two groups before and after blood collection and autologous blood transfusion(P>0.05).Conclusion:Acute equal volume blood dilution of autologous blood transfusion in the application of orthopedic surgery the changes of clinical anesthesia and hemodynamics are small,safe and effective.