急性等容血液稀释在外伤性颅内血肿患者的应用

目的探讨对外伤性颅内血肿患者实施急性等容血液稀释的操作方法及有效性。方法56例外伤性颅内血肿患者随机分为两组,对照组（C组,n=28）、血液稀释组（H组,n=28）。H组于术前即刻行等容血液稀释,目标红细胞压积（Hct）为30％。于术前（To）、手术开始后2小时（T1）分别抽取静脉血测血液流变学指标。结果To时,两组血液流变学指标相似,差异无统计学意义。T-时C组明显升高,两组间相比差异有统计学意义（P〈0．05）。结论颅脑外伤后,血液流变学指标升高,急性等容血液稀释（Hct=30％）可以降低血液黏度,改善脑挫伤后脑组织氧代谢紊乱,发挥一定的脑保护作用。

Application of acute normovolemic hemodilution in the patient with traumatic intracranial hematoma

Objective To investigate the method and its effectivity of acute normovolemic hemodilution in the patient with traumatic intracra- nial hematoma. Methods 56 patients with traumatic intraeranial hematoma were randomly divided into two groups, control group （group C, n=28）, acute hemodilution group （group H, n=28）. Group C was not hemodilutioned, group H was hemodilutioned before operation. The target hematocrit was 30%. Before operation（T0）, after two hours of the operation（T~）, blood samples were taken from venous for measurement of blood hemorheology. Re- suits At To, the hemorrheology parameters were similar in two groups, the difference was not significant. At T,, parameters in group C increased sig- nificantly, and group H significantly decreased, the difference was significant（P〈0.05）. Conclusion After traumatic brain injury, the hemorrheology parameters increased, acute normovolemic hemodilution（Hct=30%） can reduce blood viscosity and improve tissue oxygen metabolism of the brain.