不同液体进行轻度急性等容性血液稀释对腰椎融合术患者血流动力学、血气及血栓弹力图指标的影响

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Abstract Objective To investigate the effect of mild acute normovolemic hemodilution (ANH) with different fluids on indicators of hemodynamics, blood gas and thrombelastogram indicators of lumbar spinal fusion patients.Methods A total of 50 patients who underwent lumbar spinal fusion under general anesthesia in Huazhong University of Science and Technology Union Shenzhen Hospital from August 2017 to December 2019 were selected as the research subjects.The patients were divided into the hydroxyethyl starch group and the compound sodium chloride group by the random number table method, with 25 patients in each group.The two groups were treated with Hydroxyethyl Starch 130/0.4 and Compound Sodium Chloride Solution for ANH, respectively, and the hematocrit was expected to be 30% after dilution.The changes of indicators of hemodynamics, blood gas and thrombelastogram of patients in the two groups were observed before and after blood dilution.Results There were no significant differences in blood oxygen saturation(SpO2), heart rate (HR) and mean arterial pressure (MAP) 5 min before mild ANH (T1) and 15 min after mild ANH (T2)between the two groups (P＞0.05).There were no statistically significant differences in SpO2, HR and MAP at T2 in the two groups compared with those at T1 (P＞0.05).Among the indicators of thromboelastic diagram, K value at T2 in the hydroxyethyl starch group was higher than that in the compound sodium chloride group, and Angle was lower than that in the compound sodium chloride group, the differences were statistically significant (P＜0.05).The reaction time (R)value of the hydroxyethyl starch group at T2 was higher than that at T1, and its Angle was lower than that at T1, with statistical significance (P ＜0.05).There were no significant differences in coagulation time (K) and maximum clot strength (MA) at T2 in the hydroxyethyl starch group compared with those at T1 (P＞0.05).The R value and K value of the compound sodium chloride group at T2 were lower than those at T1, and the differences were statistically significant(P＜0.05).The Angle at T2 in compound sodium chloride group was higher than that at T1 in this group, and the difference was statistically significant (P＜0.05).There was no significant difference in MA value at T2 in the compound sodium chloride group compared with that at T1 (P＞0.05).There was no significant difference in the pH value at T2 of the two groups compared with that at T1 (P＞0.05).The hematocrit at T2 in the two groups was lower than that at T1, with statistical significance (P＜0.05).The level of lactic acid at T2 in the hydroxyethyl starch group was lower than that at T1,and the difference was statistically significant (P＜0.05).There was no significant difference between the lactate level at T2 and T1 in the compound sodium chloride group (P＞0.05).Conclusion In mild ANH, the uses of Hydroxyethyl Starch 130/0.4 and Compound Sodium Chloride do not significantly affect the hemodynamics of the patients.The use of Hydroxyethyl Starch 130/0.4 will direct the coagulation function of the patients to hypocoagulability, while the use of Compound Sodium Chloride will direct the coagulation function to hypercoagulability.The lactic acid level can be reduced after the use of Hydroxyethyl Starch 130/0.4.

Key words： Mild acute normovolemic hemodilution Thrombelastogram Hydroxyethyl Starch Hypocoagulability Compound Sodium Chloride Hypercoagulability Blood lactic acid

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	ZHU Hai-tao
	WANG Dan-dan
	FENG Guang-ju

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ZHU Hai-tao,WANG Dan-dan,FENG Guang-ju. Effect of mild acute normovolemic hemodilution with different fluids on indicators of hemodynamics, blood gas and thrombelastogram indicators of lumbar spinal fusion patients[J]. 中国当代医药, 2021, 28(8): 18-22转26.

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http://dangdaiyiyao.com/EN/ OR http://dangdaiyiyao.com/EN/Y2021/V28/I8/18

[14]	朱海涛，殷焱燕，奉光举，等.不同程度急性等容性血液稀释对腰椎融合术患者血乳酸水平及凝血功能的影响[J].广东医学，2019，40（20）：2917-2920.
[1]	周海洲，黄倩洁，蒋晖.不同程度急性高容量血液稀释对老年病人凝血功能和全身炎性反应的作用[J].蚌埠医学院学报，2018，43（4）：471-474.
[2]	王庚，吴新民.羟乙基淀粉急性等容性血液稀释对病人凝血状态的影响[J].中华麻醉学杂志，2006，26（12）：1104-1106.
[3]	高敏，张富军，于布为，等.等容血液稀释对家兔大出血时凝血功能的影响[J].上海交通大学学报（医学版），2010，30（9）：1125-1128.
[4]	严敏，章丽芳，徐勇.围手术期合理输血[M].北京：人民卫生出版社，2015：174-195.
[5]	刘疏影，陈彪.帕金森病流行现状[J].中国现代神经疾病杂志，2016，16（2）：98-101.
[6]	秦革萍，石小龙，杜睿，等.急性等容性血液稀释联合自体血回收与控制性降压用于手术中患者血液的保护[J].医药论坛杂志，2017，38（4）：91-93.
[7]	Ortiz AL，Vala H，Venancio C，et al.The influence of Ringer′s lactate or HES 130/0.4 administration on the integrity of the small intestinal mucosa in a pig hemorrhagic shock model under general anesthesia[J].J Vet Emerg Crit Care （San Antonio），2017，27（1）：96-107.
[8]	陶建平，屈启才，周臣，等.不同比例的乳酸林格氏液/羟乙基淀粉的目标输液对休克犬凝血的影响[J].昆明医科大学学报，2017，38（1）：51-56.
[11]	韩邦志，谢金鲜.中药止血与凝血机制的研究进展[J].广西中医药，2009，32（2）：6-8.
[12]	王同显，杨志夏.正确理解凝血机制与凝血试验的临床意义[J].中国输血杂志，2014，27（12）：1364-1346.
[13]	王学锋.血栓弹力图的临床应用评价[J].临床检验杂志，2017，35（12）：887-891.
[9]	Ponschab M，Schochl H，Keibl C，et al.Preferential effects of low volume versus high volume replacement with crystalloid fluid in a hemorrhagic shock model in pigs[J].BMC Anesthesiol，2015，15：133.
[10]	Sun Y，Yang JC，Dang QL，et al.Hemostatic function of packed red blood cells: an in-vitro study[J].Blood Coagul Fibrinolysis，2015，26（7）：784-792.
[15]	Barile L，Fominskiy E，Di Tomasso N，et al.Acute Normovolemic Hemodilution Reduces Allogeneic Red Blood Cell Transfusion in Cardiac Surgery：A Systematic Review and Meta-analysis of Randomized Trials[J].Anesth Analg，2017，124（3）：743-752.