急性高容量血液稀释联合氨甲环酸对血流动力学及血气、电解质的影响

目的:探讨急性高容量血液稀释(AHH)联合氨甲环酸(TA)对血流动力学和血气电解质的影响。方法:选择40例静吸复合全麻下行颅脑手术患者随机分为A、B两组,每组20例,A组用6%羟乙基淀粉AHH联合TA静脉注射,B组单用AHH。分别于AHH前(T0)、AHH完成即刻(T1)、AHH后1h(T2)、术毕(T3)记录MAP、CVP、HR、SpO2及血气、电解质变化。结果:A、B两组CVP在T1、T2高于T0(P<0.05);两组各时点pH、PaO2、PaCO2、BE无明显改变;两组K+、Ca2+在T1和T2均低于T0,但差异无统计学意义;两组患者Na+、Cl-在T1和T2均高于T0(P<0.05或0.01),但T3时均在正常范围。结论:6%羟乙基淀粉AHH联合TA静注,对颅脑手术患者血流动力学和血气无明显不良影响,电解质变化轻微。

Effects of acute hypervolemic hemodilution combined with tranexamic acid on hemodynamics blood gas and electrolytes

Objective To study the effects of acute hypervolemic hemodilution (AHH) combined with tranexamic acid (TA) on hemodynamics, blood gas and electrolytes. Methods Forty patients undergoing intracranial surgery were randomly divided into two groups. By intravenous injection , group A was given AHH plus TA and group B was given AHH alone. MAP、 CVP、 HR、SpO 2 , blood gas and plasma electrolytes were respectively recorded before AHH (T 0 ), at 0 min (T 1 ) and 1 h (T 2 ) after AHH, and at the end of operation (T 3 ). Results At T 1 、 T 2 , CVP of both groups were higher than that at T 0 (P < 0.05); There was no significant changes in pH, PaO 2 , PaCO 2 and BE. At T 1 、 T 2 , The concentrations of K + 、 Ca 2 + of both groups were lower than that at T 0 (P > 0.05), The concentrations of Na + 、 Cl - of both groups were higher than that at T 0 (P < 0.05 or P < 0.01, but the concentractions of these ions were still within the normal range at T 3 . Conclusion Injection of AHH with 6% hydroxyethyl starch combined with TA has no adverse effect on hemodynamics and blood gas and minor changes in electrolytes of the patients undergoing intracranial surgery are detected.