急性血液稀释对孕产妇失血性休克术中循环及凝血功能的影响(1)
[摘要] 目的：研究急性血液稀释在孕产妇失血性休克中对循环及凝血功能的影响。方法：选择孕产妇合并失血性休克患者50例，随机分为对照组(Ⅰ组)和急性等容性血液稀释(ANH)组(Ⅱ组)，每组25例。Ⅱ组于麻醉后、手术之前，在15～25 min内经颈内静脉加压输入RLS及6% HES 15～30 ml/kg(晶∶胶＝1∶1)，使血容量迅速恢复。Ⅰ组除外血液稀释，其余处理同Ⅱ组。组间和组内比较各时点血流动力学、Hct、Hb、PLT、 输血量及凝血功能等的变化。结果：血液稀释完成即刻(T1)，Ⅱ组各生命指征与入室时(T0时点)比较，差异有非常显著性(P<0.01)，显示休克生命征明显缓解；T1时点Ⅱ组各生命征与Ⅰ组比较，休克生命征缓解，有非常显著性差异(P<0.01)。Ⅱ组Hb、Hct和PLT、APTT、PT、FiB 在T1时点较T0时点差异有非常显著性(P<0.01)，显示血液明显稀释；输血量Ⅱ组明显少于Ⅰ组(P<0.01)。结论：急性血液稀释能迅速缓解孕产妇合并失血性休克患者的休克生命征，对凝血功能的影响并不影响患者的抢救成功率和治愈率，值得临床推广。
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[关键词] 血液稀释；异位妊娠；产妇；失血性休克；抢救
[中图分类号] R459.7 [文献标识码]A [文章编号]1673-7210(2007)12(b)-031-03
The effect of acute hemodilution on the circulation and the blood coagulation in the hemorrhagic shock operation for pregnant and pregnant women
GUAN Kai-hua , DENG Qun-bo , DAI Jing-hua ,LIU Dong-yan,QIN Yan-fen,LIANG An-wei
(The First People's Hospital of Hechi of Guangxi, Yizhou546300, China)
, 百拇医药
[Abstract] Objective:Explore the effects of acute hemodilution on the circulation and blood coagulation in the hemorrhagic shock operation for pregnant and pregnant women. Methods:50 pregnant and pregnant women with hemorrhagic shock were recruited. They were equally divided into two groups: ⅠControl group,ⅡAcute normvolemic hemodilution (ANH) group. The 25 patients of group Ⅱ were pressurly infused in RLS and 6% HES , altogether 15～30 ml/kg ( crystalylloid liquid: colloidal liquid＝1∶1) through vena jugularis interna during the 15～25 minutes between anesthesia and operation, so that the blood volume would be restored quickly. The patients of the control group(I) were treated the same as the second group except the hemodilution. Then a close observation was made on the change of blood flow mechanics, Hct, Hb, PLT, blood transfusion amount, and blood coagulation inside and between the groups at different time points. Results:At the time point T1, when the hemodilution was finished, the vital signs of the patients of gro colloidal colloidal were significantly different from those at time point T0, when patients entered the operating room(P<0.01), which shows that the vital signs of the patients are relieved obviously(P, http://www.100md.com(关开华 邓群波 戴静华 刘冬艳 覃艳芬 梁安伟)
, http://www.100md.com
[关键词] 血液稀释；异位妊娠；产妇；失血性休克；抢救
[中图分类号] R459.7 [文献标识码]A [文章编号]1673-7210(2007)12(b)-031-03
The effect of acute hemodilution on the circulation and the blood coagulation in the hemorrhagic shock operation for pregnant and pregnant women
GUAN Kai-hua , DENG Qun-bo , DAI Jing-hua ,LIU Dong-yan,QIN Yan-fen,LIANG An-wei
(The First People's Hospital of Hechi of Guangxi, Yizhou546300, China)
, 百拇医药
[Abstract] Objective:Explore the effects of acute hemodilution on the circulation and blood coagulation in the hemorrhagic shock operation for pregnant and pregnant women. Methods:50 pregnant and pregnant women with hemorrhagic shock were recruited. They were equally divided into two groups: ⅠControl group,ⅡAcute normvolemic hemodilution (ANH) group. The 25 patients of group Ⅱ were pressurly infused in RLS and 6% HES , altogether 15～30 ml/kg ( crystalylloid liquid: colloidal liquid＝1∶1) through vena jugularis interna during the 15～25 minutes between anesthesia and operation, so that the blood volume would be restored quickly. The patients of the control group(I) were treated the same as the second group except the hemodilution. Then a close observation was made on the change of blood flow mechanics, Hct, Hb, PLT, blood transfusion amount, and blood coagulation inside and between the groups at different time points. Results:At the time point T1, when the hemodilution was finished, the vital signs of the patients of gro colloidal colloidal were significantly different from those at time point T0, when patients entered the operating room(P<0.01), which shows that the vital signs of the patients are relieved obviously(P, http://www.100md.com(关开华 邓群波 戴静华 刘冬艳 覃艳芬 梁安伟)