术前急性等容血液稀释联合术中自体血回收在颅脑外科手术中的应用.DOC

术前急性等容血液稀释联合术中自体血回收在颅脑外科手术中的应用研究 唐纯海1 ，吴全理2 （1．钦州市第一人民医院 钦州535000;2.北海市人民医院 北海 536000） 【摘要】　目的:探讨术前急性等容血液稀释联合术中自体血回收在颅脑择期手术中对患者凝血功能的影响以纠正贫血的作用。方法:16 例神经外科择期手术患者,分别于手术开始前、血液等容稀释后，止血基本完成时、回输机采自体血以及术前采集自体血后检测患者APTT、PT、FLB、Plt、Hb、Hct；结果:等容稀释后和术前比较患者凝血功能无明显变化，Hb, Hct明显下降；回输血前和术前相比患者的凝血状态明显变化，Hb, Hct明显下降； 输机采血后和回输血前比较Plt进一步下降,但APTT,PT，FLB无明显变化,同时Hct及HB明显升高；输自体动脉血后和回输血前比较患者的PLT，FLB明显升高, APTT ,PT明显缩短，Hct，HB及RBC进一步升高。结论:在出血量较大的神经外科手术中使用术前急性等容血液稀联合术中自体血回收对改善纠正患者贫血，维持患者血流动力学稳定，保证患者术后正常凝血功能，增加手术安全性方面是非常有益的 关键词　 急性等容稀释 术中自体血回收　颅脑手术 中图分类号: 　文献标识码:　 The research of Preoperative Acute Normovolemic Hemodilution Combined with Intraoperative Autologous Blood Recovery Application in the Surgery of Craninal Tang Chunhai 1, Wu Quanli 2 (1.the first People’s Hospital of QinZhou QinZhou 535000；2.the People’s Hospital of BeiHai 53600) 【Abstract】:Objective :to investigate the patients’ blood coagulation function and the function of correction of anemia as preoperative acute normovolemic hemodilution combined with intraoperative autologous blood recovery is used in elective surgery of brain.methods: sixteen elective neurosurgery patients were included,their`s APTT, PT, FLB, Plt, Hb, Hct were tested respectively at the time of before surgery, acute normovolemic hemodilution, the bleeding basically completed, after transfusion apheresis of autologous blood and the preoperative collection of autologous blood. results : there were no significant changes between patients after normovolemic hemodilution and patients preoperative in their PLT,APTT,PT ,FLB ,but the patients’ Hb, Hct, decreased significantly; when the bleeding basically completed the patients’ PLT,APTT,PT, FLB,Hb, Hct, decreased significantly compared with preoperative; as compare to the bleeding basically completed, there were no significant changes in the transfusion apheresis of autologous blood patients’ APTT,PT, FLB, the patients PLT further declined , but the patients Hb, Hct, increased significantly;Compared to the bleed