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急性等容血液稀释对心脏手术病人血液动力学 氧供 氧耗和脑氧合的影响 |
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关婷婷 吴新民 朱姜华
摘要 目的:了解急性等容血液稀释对心脏直视手术病人可能产生的影响,以指导其在体外循环中的应用。方法:观察16例ASAⅡ~Ⅲ级择期心脏直视手术病人,接受体外循环前实施急性等容血液稀释,监测病人血液动力学、氧供、氧耗、乳酸浓度及颈内静脉血氧饱和度等指标的变化。结果:血液稀释后病人的心指数增加了15.5%,氧供和氧耗无显著变化,氧摄取率无显著变化。颈内静脉血氧饱和度、动脉血乳酸浓度及颈内静脉血乳酸浓度无明显改变。结论:急性等容血液稀释(10ml/kg左右)对于术前血红蛋白浓度正常的心脏手术病人安全有效。 关键词 血液稀释 氧消耗 脑氧合 血液动力学
Effects of acute normovolemic hemodilution on hemodynamics,oxygen delivery/consumption and cerebral oxygenation during cardiac surgery Guan Tingting,Wu Xinmin,Zhu Jianghua.Department of Anesthesiology,the First Hospital of Beijing Medical University,Beijing 100034 Abstract Objective:To investigate the effects of acute normovolemic hemodilution(ANHD) on hemodynamics,oxygen delivery/consumption and cerebral oxygenation during cardiac surgery.Method:In 16 patients (ASA grade Ⅱ-Ⅲ) undergoing selective cardiac surgery, ANHD was accomplished by colloid solution(10ml/kg body weight ) after induction of anesthesia.The hemodynamics,oxygen delivery/consumption,lactate concentration and internal jugular venous blood oxygen saturation were monitored during the surgery.Result:After ANHD the cardiac index(CI) increased by 15.5%(P<0.05),oxygen delivery/consumption and oxygen extraction ratio did not change.Internal jugular venous blood oxygen saturation and lactate concentration of both arterial and internal jugular venous blood did not change.Conclusion:ANHD(10ml/kg body weight) after induction is a safe and effective technique of autotransfusion for cardiac surgery patients with normal hemoglobin level before operation. Key words Hemodilution Oxygen consumption Cerebral oxygenation Hemodynamics
本实验的目的是对心脏直视手术病人实施急性等容血液稀释并监测血液动力学、氧供、氧耗、乳酸及颈内静脉血氧饱和度等指标的变化,了解急性等容血液稀释对该类病人可能产生的影响,以指导其在体外循环中的应用。
资料和方法
病例选择 选择16例ASAⅡ-Ⅲ级心脏手术病人,其中行冠状动脉搭桥术11例,瓣膜置换术4例,左房巨大粘液瘤摘除术1例;男性10例,女性6例;年龄53.9±11.7岁,体重66.9±11.6kg;术前血红蛋白126±15g/L,所有病人术前无肝、肾功能异常。 麻醉方法 病人给予心脏手术常规术前药。入室后右肘正中静脉置管用于输液,左桡动脉置管用于测定动脉压[1] [2] 下一页 上一个医学论文: 七氟醚 异氟醚对维库溴铵增效作用的时间依赖性 下一个医学论文: 咪唑安定用于预防颈丛阻滞下甲状腺术中应激反应的观察
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