急性非等容性血液稀释联合氨甲环酸对脑肿瘤手术患者循环功能和血气电解质的影响

发布时间：2018-09-12 18:37

【摘要】：目的:探讨急性非等容血液稀释(ANIH)联合氨甲环酸(TA)对脑肿瘤手术患者循环功能和血气电解质的影响。方法:择期脑肿瘤患者42例,随机分成两组,每组21例,ANIH+TA组(A组)行ANIH并静注TA 10 mg/kg,ANIH组(B组)单用ANIH。记录两组麻醉诱导后ANIH前(T1)、ANIH后即刻(T2)、ANIH后1 h(T3)和自体血回输后(T4)HR、CVP、MAP和血气电解质变化情况,并比较各时点Hb和Hct改变。结果 :HR、CVP、MAP组间及组内差异无统计学意义。与T1比较,两组Hb、Hct在T2、T3、T4时显著降低(P0.05);T4时,A组Hb、Hct大于B组(P0.05)。两组pH、PaO2、PaCO2、BE值组间及组内比较差异无统计学意义。两组K+、Na+、Cl-、Ca2+组间及组内比较差异无统计学意义。结论:ANIH对循环功能以及血气电解质影响不大,联合TA可安全用于脑肿瘤手术,两者联合应用有一定的节血效应。
[Abstract]:Objective: to investigate the effects of acute nonisovolemic hemodilution (ANIH) combined with (TA) on circulatory function and blood gas electrolyte in patients with brain tumor. Methods: 42 patients with brain tumor were randomly divided into two groups: 21 patients in each group were treated with ANIH and TA 10 mg/kg,ANIH group (group B) were treated with ANIH and TA 10 mg/kg,ANIH group (group B). The changes of HR,CVP,MAP (T 3) and blood gas electrolyte (T 4) at 1 h (T 3) and after autologous blood transfusion (T 4) were recorded before and immediately after ANIH induction in both groups, and the changes of Hb and Hct were compared at each time point. Results there was no significant difference in CVPMAP between groups and within groups. Compared with T1, the Hb,Hct of group A was significantly lower than that of group B at T2T3T4 (P0.05). There was no significant difference in pH,PaO2,PaCO2,BE between and within the two groups. There was no significant difference between the two groups. Conclusion the effects of TA on circulation function and blood gas and electrolyte were not significant, and combined with TA could be safely used in brain tumor surgery, and the combined use of the two methods had a certain blood saving effect.
【作者单位】：桂林医学院第二附属医院麻醉科;桂林医学院附属医院麻醉科;桂林医学院附属医院门诊部;桂林医学院附属医院检验科;
【基金】：广西壮族自治区卫生厅计划课题(编号:Z2014300) 广西高校科学技术研究项目(编号:KY2015LX253)
【分类号】：R614;R739.41

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