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The effect of acute non-isovolemic hemodilution on the intracranial pressure and coagulative function during nuerosurgery
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- Author:
- No author available
- Journal Title:
- CHINESE JOURNAL OF PRIMARY MEDICINE AND PHARMACY
- Issue:
- 4
- DOI:
- 10.3760/cma.j.issn.1008-6706.2003.04.001
- Key Word:
- 血液稀释;开颅;颅内压;凝血功能
Abstract： 目的探讨急性非等容血液稀释对开颅病人的颅内压和凝血功能的影响.方法选择择期开颅肿瘤切除病人18例,麻醉诱导前行蛛网膜下腔穿刺,监测颅内压(ICP),并由足背动脉放血400～600 ml,开始诱导同时经外围静脉快速补充2～2.5倍于采血量的等效胶体和晶体.麻醉采用静吸复合全麻,术中连续监测有创血压、心率、氧饱和度,分别于血液稀释前后监测ICP,中心静脉压(CVP)、活化部分凝血活酶(APTT)、凝血酶原时间(PT)、凝血因子Ⅰ(FIB)、血小板(PLT)、血球压积(HCT).结果与血液稀释前相比,血流动力学稳定;PT明显延长(P＜0.05),PLT、HCT明显降低(P＜0.05),但仍在正常范围内,APTT、FIB差异无显著意义(P＞0.05);颅内压无明显增高.结论急性非等容血液稀释对开颅手术病人的颅内压和凝血功能无明显影响,是一种安全有效的、简便的血液保护方法.
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