术前禁食禁饮对老年择期手术患者血液浓稠性和集聚性的影响

目的观察术前禁食禁饮对老年择期手术患者血液稠性和集聚性的影响。方法随机选择40例择期手术患者,年龄〉65岁,ASAⅠ～Ⅱ级,分为A、B两组,A组20例为禁食禁饮12h组（禁食禁饮组）;B组20例为禁食禁饮12h＋术前10h饮水10ml/kg组（禁食饮水组）。A组分为两个抽血时点,B组也分为两个抽血时点。分别于在4个时点抽取患者肘正中静脉血,测定血液浓稠性和集聚性指标。结果①禁食禁饮前后比较：禁食后的血细胞比容（HCT）轻度升高;全血还原粘度（re）略有升高;血沉（ESR）增块;血沉方程K值（ESRK）无明显差异;红细胞电泳时间（EPT）延长。②禁食饮水前后比较：饮水后的HCT轻度减低;re略有升高;ESR轻微减慢;ESRK无明显差异;EPT在正常范围。结论术前禁食禁饮对老年患者可导致血液浓缩、红细胞聚集性增强等;术前10h适量饮水可以在一定程度上改善患者因禁食禁饮所致的血液流变学变化。

Effects of fast and no-drinking water on blood concentrating and accumulating in selective surgical patients during pre-operation in elderly patients

Objective To observe effects of fast and no-driking water on blood concentrating and accumulating in selective surgical patients during pre-operation in elderly patients.Methods Forty patients,age65 years old,ASAⅠ～Ⅱ,were divided randomly into two groups with 20 cases each.The patients of group A were received fast for 12 hours during pre-operation and those of group B were received drinking-water 10ml/kg for 10 hours pre-operation.The patients of group A were divived into two taken-blood points;The patients of group B were also divived into two taken-blood points,the first point was pre-fast and before drinking water;the second point was after fast and after drinking water.All blood sample of two groups were tested for the blood concentrating and accumulating measurements. Results In group-after fast.HCT,ESR,ESRK,etc.were higher than those in pre-fast;whole blood restoring viscosity（re）increased slightly in group-after Ingroup-after fast,drinking water blood;HCT,ESR,ESRK in group-after drinking water were similar to those in group-before drinking water.However,in group-after drinking water,HCT,ESR,ESRK,EPT in group-after fast were higher than those in group-after drinking water.Conclusion After fast and no-drinking water for 12 hours during pre-operation,the elderly patients for selective surgical operations exist some homorheological changes characterized by increased HCT,ESR,ESRK,etc.Drinking water at 10 hours pre-operation might improve the hemorheologica conditions.