急性等容性血液稀释在脊柱手术中对血小板功能的影响

目的探讨急性等容性血液稀释（ANH）在脊柱手术中对患者血小板功能的影响。方法择期全麻下行脊柱手术患者20例,术前行颈内静脉穿刺采自体血,同时于外周静脉输入等量的胶体液（万汶）,术中连续监测HR,SPO2,Bp及尿量变化,分别于采血前（T0）,采血后15 min（T1）,输血前（T2）,输血后15 min（T3）,抽取桡动脉血查HB,HCT,LAC,并采用Sonoclot分析仪测定激活凝血酶原时间（ACT）,凝血速率（CR）,血小板功能（PF）。记录术中晶胶体液输入量,出血量和尿量。结果与T0相比,T1的HB,HCT显著下降（P〈0.01）,CR、PF显著下降（P〈0.01）,与T2相比,T3的HB,HCT显著回升,CR、PF显著升高（P〈0.01）,LAC,ACT变化无统计学意义。结论急性等容性血液稀释对脊柱手术患者血小板功能有一定的保护作用,对凝血功能无明显不良影响。

Effect of Acute Normovolemic Hemodilution on Platelet Function in Spine Surgery

Objective To investigate the effect of acute normovolemic hemodilution on platelet function in patients undergoing spine surgery. Methods A total of twenty patients undergoing spine surgery were collected the autologous blood by internal jugular vein puncture before operation and the equivalent dose hydroxyethyl starch were infused at the same time. During the operation, the changes of HR, SPO2, Bp and urine output were monitored. Then the changes of HCT, HB, LAC, ACT, CR, PF at 15 minutes before （TO） and after （T1） vein blood sampling, at 15 minutes before （T2） and after （T3） autotransfusion were monitored. Results Compare with TO, HB, HCT, CR, PF decreased at T1; Compare with T2, HB, HCT, CR, PF raised at T2. There were no statistically significant in LAC and ACT. Conclusion Platelet no adverse effects on blood function could be shielded in patients with ANH undergoing spine surgery and coagulation.