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急性等容性血液稀释在口腔颌面外科手术中的临床应用

The clinical application of acute normovolaemic haemodilution in oral and maxillofacial surgeries.

作者信息

Goel Poonam, Bhola Nitin, Borle R M, Datarkar Abhay, Verma Dinesh

出版信息

J Maxillofac Oral Surg. 2010 Dec;9(4):396-402. doi: 10.1007/s12663-010-0129-1. Epub 2011 Mar 10.

DOI:10.1007/s12663-010-0129-1
PMID:22190832
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC3177469/
Abstract

AIM

The aim of the study is to assess the efficacy of Acute Normovolaemic Haemodilution (ANH) in reducing the perioperative homologous transfusion, to compare the results of acute normovolaemic haemodilution and homologous blood transfusion in terms of Hb%, PCV%, and to assess the cost effectiveness of ANH with homologous transfusion.

METHODS

30 healthy patients between the age of 14-70 years, who required a maxillofacial surgical procedure under general anaesthesia with haemoglobin level of 12 gm% or above, PCV 30% or above and where postoperative blood transfusion was not expected to be beyond one pint, were selected. The patients were randomly divided into two groups of 15 patients each. The group I patients were subjected to ANH and the group II patients were transfused 1 pint of compatible banked, homologous blood and mean haemoglobin and PCV was compared in 1st, 3rd and 7th post-operative day in both the groups.

RESULT

Patients who received ANH had p < 0.05 than patients who received homologous transfusion by using student's paired t-test in terms of Hb% and PCV%.

CONCLUSION

It was concluded that ANH is more effective compared to homologous bleeding time.

摘要

目的

本研究旨在评估急性等容性血液稀释(ANH)在减少围手术期同种异体输血方面的疗效,比较急性等容性血液稀释和同种异体输血在血红蛋白百分比(Hb%)、红细胞压积(PCV%)方面的结果,并评估ANH与同种异体输血的成本效益。

方法

选取30例年龄在14至70岁之间、需要在全身麻醉下进行颌面外科手术、血红蛋白水平在12克%或以上、PCV在30%或以上且预计术后输血量不超过一品脱的健康患者。将患者随机分为两组,每组15例。第一组患者接受ANH,第二组患者输注1品脱相容的库存同种异体血,并在两组术后第1天、第3天和第7天比较平均血红蛋白和PCV。

结果

在Hb%和PCV%方面,通过学生配对t检验,接受ANH的患者与接受同种异体输血的患者相比,p<0.05。

结论

得出的结论是,与同种异体输血相比,ANH更有效。

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本文引用的文献

1
Prospective randomized controlled trial of acute normovolaemic haemodilution in major gastrointestinal surgery.重大胃肠手术中急性等容性血液稀释的前瞻性随机对照试验。
Br J Anaesth. 2004 Dec;93(6):775-81. doi: 10.1093/bja/aeh279. Epub 2004 Oct 1.
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Immunological aspects of blood transfusions.输血的免疫学方面。
Transpl Immunol. 2002 Aug;10(2-3):183-90. doi: 10.1016/s0966-3274(02)00064-3.
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Acute normovolaemic haemodilution decreases postoperative allogeneic blood transfusion after total knee replacement.
Br J Anaesth. 1997 Sep;79(3):317-21. doi: 10.1093/bja/79.3.317.
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Postoperative inflammatory response after autologous and allogeneic blood transfusion.
Anesthesiology. 1997 Sep;87(3):511-6. doi: 10.1097/00000542-199709000-00009.