不同容量治疗的方案对硬膜外麻醉下急诊骨科手术患者效果比较.docVIP

不同容量治疗的方案对硬膜外麻醉下急诊骨科手术患者效果比较 　　[摘要] 目的:探讨不同容量治疗方案对硬膜外麻醉下急诊骨科手术患者治疗效果的影响。方法:收集急诊骨科手术患者100例,随机分为两组。两组患者一般情况比较,差异无统计学意义,具有可比性。所有患者进行硬膜外麻醉,高容量血液稀释组快速输入6%羟乙基淀粉;对照组常规输液。比较两组MAP、HR、CVP、Hct及Hb的变化情况。结果: Ⅰ组患者MAP、HR变化与术前比较,差异无统计学意义;CVP略有增高,但在正常范围内。Ⅱ组患者术后与术前比较MAP、CVP降低,HR增快。Ⅰ组患者术后与术前比较,Hb、Hct略有降低;Ⅱ组患者术后Hb、Hct明显降低,与术前比较,差异有统计学意义。结论:急性高容量血液稀释,可提高急诊骨科手术患者对失血的耐受性,对维持手术患者机体内环境稳态有积极意义,操作简便、安全有效。 　　[关键词] 骨科手术;麻醉;血液稀释 　　[中图分类号] R614.4+2 [文献标识码]A [文章编号]1674-4721(2010)07(a)-044-02 　　 　　Treatment of different capacity on emergency orthopedic surgery under epidural anesthesia in patients comparison 　　NONG Jiazhen1,LUO Jianxing2,LU Mingyan2 　　(1.Panyu District,Guangzhou City,Anesthesiology Nut in Guangdong Province,Guangzhou 511480,China;2. Panyu District, Guangzhou City, Lam nuclear Hospital Surgery in Guangdong Province,Guangzhou 511480,China) 　　[Abstract] Objective:Comparison the effects on patients undergone bone surgery use epidural anesthesia and different capacity treatment.Methods:Collected 100 cases of emergency orthopedic surgery patients,randomly divided into two groups.Two groups of patients in general compare,the difference was not significant.All patients with epidural anesthesia.Hypervolemic hemodilution group of fast input of 6% hydroxyethyl starch,control group give conventional infusion.Compared three groups of MAP,HR,CVP,Hct and Hb changes.Results:Ⅰ group of MAP,HR compared with the preoperative difference was not statistically significant;CVP increased slightly,but within the normal range.Ⅱ group patients compared with the preoperative MAP,CVP decreased,HR faster.Ⅰ group were compared with preoperative,Hb,Hct decreased slightly;Ⅱ group of patients Hb,Hct decreased significantly compared with the preoperative,the difference was statistically significant.Conclusion:Acute hypervolemic hemodilution in patients undergoing orthopedic surgery can improve the acute tolerance to blood loss,surgical patients on the body to maintain homeostasis are positive,simple,safe and