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人体术中预出血:胶体血液稀释对血容量、肺水、血流动力学和氧运输的影响。

Intraoperative prebleeding in man: effect of colloid hemodilution on blood volume, lung water, hemodynamics, and oxygen transport.

作者信息

Laks H, Pilon R N, Anderson W, McCallum J R, O'Connor N E

出版信息

Surgery. 1975 Aug;78(2):130-7.

PMID:1154256
Abstract

The effects of acute normovolemic hemodilution on lung water, blood volume, hemodynamics, and oxygen transport were studied. The subjects were six patients undergoing major operations, with prebleeding and hemodilution under fluoroxene and nitrous oxide anesthesia. The menatocrit was reduced form 43 to 25 percent in one step, with simultaneous infusion of Plamanate and lactated Ringer's solution. Blood volume was expanded by 5 percent by the hemodilution. The major compensation was a striking rise in cardiac output to 161 percent. Systemic oxygen transport (CO times arterial O2 content) increased despite the marked fall in oxygen-carrying capacity, and the arteriovenous O2 content difference decreased. Lung water the aveolararterial (A-a) oxygen differences were reduced. The procedure was well tolerated by this group of selected patients and homologous blood utilization was reduced.

摘要

研究了急性等容血液稀释对肺水、血容量、血流动力学和氧输送的影响。受试者为6例接受大手术的患者,在氟烷和氧化亚氮麻醉下进行术前采血和血液稀释。血细胞比容一步从43%降至25%,同时输注血浆蛋白和乳酸林格氏液。血液稀释使血容量增加了5%。主要的代偿是心输出量显著增加至161%。尽管氧携带能力显著下降,但全身氧输送(心输出量乘以动脉血氧含量)增加,动静脉血氧含量差减小。肺水和肺泡-动脉(A-a)氧差减小。这组选定的患者对该操作耐受性良好,且减少了同源血的使用。

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