【摘要】 目的:探索控制性低血压联合高容量血液稀释的血液保护效果。方法:33例ASAI～II级行择期神经外科 手术的患者随机进入对照组(单纯控制性低血压组,n=17)与实验组(控制性低血压高容量血液稀释联合组,n =16)。对照组手术中平均动脉压维持于55mmHg～60mmHg;实验组采用同样的低血压水平,且在此基础上 大量输入6%羟乙基淀粉与乳酸林格液的混合液体,使手术中血球压积降低至接近25%。比较两组患者手术 失血量、库血输入量、尿量等指标。结果:两组患者的手术失血量、库血输入量无显著差别。实验组手术中尿量 明显多于对照组。结论:控制性低血压联合高容量血液稀释技术血液保护的效果与单纯的控制性低血压技术 相当,但联合技术对改善低血压下的内脏灌注有益。更多还原

【Abstract】 Objective:To Compare the blood conservation efficacy of controlled hypotension alone and controlled hypotension combined with acute hypervolemic hemodilution.Methods:Thirty three ASA physical status I and II patients who were scheduled to receive neurosurgical operation were randomly divided into two groups:a controlled hypotension alone group ( n =17) and a controlled hypotension hypervolemic hemodilution combined group ( n =16). Controlled hypotension induced by isoflurane nitroprusside esmolol to maintain mean arterial pressure at 55 mmHg~60 mmHg. Hypervolemic hemodilution (hematocrit down to 25%)was produced by preoperative infusion of 6% hydroxyethyl starch solution and Ringers solution without blood removing.Results:There was no difference in blood loss and homologous transfusion requirements between controlled hypotension group and the combined group.Urine output in the controlled hypotension group was significantly less than that in the combined group.Conclusion:The blood sparing efficiency of controlled hypotension combined with hypervolemic hemodilution is similar to that of controlled hypotension alone.Combined technique does not impair splanchnic perfusion,whereas controlled hypotension alone might cause impairment.更多还原