急性超容血液稀释结合血凝酶用于全髋置换术节约用血的临床观察

目的观察急性血液稀释结合血凝酶用于全髋置换术节约用血的可行性和安全性。方法选择ASAⅠ～Ⅱ级择期全髋置换手术134例,随机分为Ⅰ组(不行急性超容液稀释)和Ⅱ组(行急性超容液稀释结合血凝酶),观察术中血压(BP)、心率(HR)、血小板计数(Platelet count,PLT)、凝血酶原时间(Prothrombin time PT)、部分凝血活酶时间(Actiaved partial thromboplastin time,APTT)、失血量和输血量。结果①两组失血量及输血量比较差异均有统计学意义(P<0.05)。②Ⅱ组BP在麻醉后、术中以及术后维持相对稳定,与Ⅰ组变化比明显,两组不同时间点BP比较差异均有统计学意义(P<0.05)。③两组血小板计数均下降,和术前比较差异均有统计学意义(P<0.05),两组间比较,差异均无统计学意义(P>0.05)。结论术前急性高容血液稀释结合立止血,可安全地应用于全髋关节置换术患者。

Clinical Observation of Acute Hemodilution with Thrombin in Total Hip Replacement for Blood Saving

Objective To explore the feasibility and security of acute hemodilution with thrombin in total hip replacement for blood saving. Methods 134 cases with total hip replacement （ ASA Ⅰ-Ⅱ） was ineuded. They are divided into Ⅰ group without acute hemodilution and Ⅱ group with acute hemodilition randomly, many aspects were observed, such as blood pressure, heart rate, Platelet count, prothrombin time, activated partial thromboplastin time, quantity of blood loss and blood transfusion. Results （1） There is obviously significance in quantity of blood loss and blood transfusion between two groups（ P 〈 0.05 ）. （2）Tbe blood pressure of Group Ⅱ are relative stable after anesthesia,during and after operation, which were significantly different from that of Group Ⅰ at different time points. （ P 〈 0.05 ）. （3）The Platclet count of two group were all significantly decreased after operation. （ P 〈 0.05 ） , there is no significantly difference between two group （ P 〉 0.05 ）. Conclusion Acute hemodilution with Reptilase can be safely used on the patients of Total Hip Replaceme before the operation.