急性等容血液稀释对血液成份及凝血功能的影响

目的：了解急性等容血液稀释对血液成份及凝血功能的影响，方法：选择20例估计出血量多的大手术患者，随机分为急性等容血液稀释组（简称稀释组）和对照组，每组10例，稀释组术前进行急性等容血液稀释，预计把Hct稀释至30％，监测并比较两组血液稀释毕，术毕，术后第1天，第7天Hb,Hct,Plt,Alb,Pt,Aptt,Fg变化，结果：稀释组稀释毕，术毕，术后第1天，第7天及对照组术毕，术后第1天，第7天，Hb,Hct,Plt值均极显著低于术前值（P＜0．01），稀释组术毕，术后第1天Hb,Hct极显著低于对照组同期值（P＜0．01），但第7天两组则无差别，两组术毕，术后第1天，第7天Alb显著低于术前值（P＜0．05），但两组上述各监测值均仍在安全范围内；两组稀释毕及术毕，术后Pt,Aptt,Fg与术前相比无差别（P＞0．05），结论：急性等容血液稀释可使患者Hb,Hct,Plt较显著下降，但经控制好稀释程度仍可维持在安全范围内，而结凝血功能影响轻微。

The effects of acute isovolemic hemodilution on patients' blood components and blood coagulation

Objective To study the effects of acute isovolemic hemodilution (AIVH) on patients' blood components and blood coagulation. Methods 20 patients undergoing major operation were divided into 2 groups randomly: AIVH group ( n =10) and control group ( n =10). AIVH with hematocrit of 30% was accomplished preoperatively by exchanging whole blood with Hemaccel. Hb, Hct, Plt, Alb, Pt, Aptt and Fg were measured and compared between both of the groups before and after the hemodilution, at the end of operation, 1d and 7d after operation. Results Hb, Hct and Plt decreased remarkably after the hemodilution in AIVH group, and which also decreased obviously at the end of operation, 1d and 7d after operation in both groups ( P <0.01); compared with control group, Hb and Hct decreased remarkably at the end of operation and 1d after operation in AIVH group, but had no significant difference 7d after operation; Compared with pre-operation, Alb decreased obviously at the end of operation, 1d and 7d after operation in both groups ( P <0.05). All the measurements mentioned above were still within normal range. Compared with pre operation, Pt, Aptt and Fg haven't change a bit at the end of and after operation. ( P >0.05). Conclusion Hb, Hct and Plt can be decreased remarkably by AIVH and still be within the normal range by controlling the hemodilution with little effect on the function of blood coagulation.