西藏高原先心病患者围心脏手术期血液流变学分析

目的探讨西藏高原先心病患者心脏手术期间的血液流变学变化.方法观察高原组(12例)和平原组(12例)患者术前、转流30分、停机后、术后1天、术后3天、术后5天及术后7天的不同切变率下的全血粘度、血浆粘度、全血还原粘度、红细胞压积、红细胞刚性指数及红细胞聚集指数.结果转流期间的各切变率下的全血粘度、血浆粘度均降低(P<0.05),术后1天恢复;红细胞压积、红细胞聚集指数也降低(P<0.05),术后7天才恢复;红细胞刚性指数升高(P<0.05),术后7天恢复.除红细胞刚性指数高原组小于平原组(P<0.05),其他指标高原组均大于平原组(P<0.01).结论高原先心病患者围心脏手术期全血粘度、红细胞聚集性高,红细胞变形性较好,采用控制性稀释技术,有利于微循环灌注.

Analysis of Hemorheology for Congenital Heart Disease Perioperative on Tibet Platera

Objiective:To study the change of hemorheology for cogenital heart disease during cardiopulmonary bypass on Tibet Plateru.Method Date from 12 patients of plain group and 12 patients of plateau group were compared including whole blood viscosity,plasma viscosity,whole blood viscosity hematocrit,erythrocyte rigid index,erythrocyte aggregation index of various shear rate during CPB 30 minutes,out of CPB,one day,three day,five day,seven day after surgery,respectively.Results Plasma viscosity and whole blood viscosity reduced during CPB and restored one day after surgery;hematocrit and erythrocyte aggregation index also reduced,and restored seven day after sugery;eryghrocyte rigid index was lower on plateau than on plain,but the other was higher on plateau than on plain.Conclusion Whole blood viscosity,erythrocyte aggregation index,erythrocyte transformation were better on plateau than on plain.Controlled dilute technique is benefit to microcirculation perfusion.