Wu Jinguang, Zhang Zhilei
Department of Urologic Surgery, Shengli Hospital of Dongying Dongying 257000, Shandong Province, China.
Am J Transl Res. 2021 Jul 15;13(7):7866-7873. eCollection 2021.
To compare the effect of acute hypervolemic hemodilution and conventional infusion in prostate cancer patients undergoing laparoscopic radical prostatectomies.
A total of 87 patients with prostate cancer who underwent laparoscopic radical prostatectomies in our hospital were retrospectively analyzed. The patients were randomly divided into a control group (the CNG, n=43, conventional infusion) and an observation group (the OG, n=44, acute hypervolemic hemodilution). Blood gas analyses were performed at different time points, and the patients' cognitive dysfunction was evaluated.
The intraoperative blood transfusion rates of the OG and the CNG were 11.36% and 30.23%. The average intraoperative blood transfusions in the OG and the CNG were (315.46±24.49) ml and (486.95±42.17) ml ( < 0.05). The CVP and JVP levels in the OG and the CNG at T2 and T3 were significantly higher than the levels at T0 ( < 0.05). The Hb levels of the CNG at T3 and T4 were lower than they were at T0 ( < 0.05), and the Hb level in the OG at T4 was lower than it was at T1 ( < 0.05). The Hb levels in the CNG at T3 and T4 were lower than they were at T1 ( < 0.05), and the Hb levels in the OG at T1 and T2 were lower than they were in the CNG ( < 0.05). The MMSE cognitive function scores were lower than the scores recorded on the day before the operations ( < 0.05).
Acute hypervolemic hemodilution in laparoscopic radical prostatectomy patients can maintain their hemodynamics in a stable state, help reduce blood transfusion, improve the oxygen supply to the brain tissue to maintain the supply and demand balance, and reduce the impact on the patients' cognitive function.
比较急性高容量血液稀释与传统输液在接受腹腔镜根治性前列腺切除术的前列腺癌患者中的效果。
回顾性分析我院87例接受腹腔镜根治性前列腺切除术的前列腺癌患者。患者被随机分为对照组（CNG组，n = 43，传统输液）和观察组（OG组，n = 44，急性高容量血液稀释）。在不同时间点进行血气分析，并评估患者的认知功能障碍。
OG组和CNG组的术中输血率分别为11.36%和30.23%。OG组和CNG组的术中平均输血量分别为(315.46±24.49)ml和(486.95±42.17)ml（P<0.05）。OG组和CNG组在T2和T3时的中心静脉压（CVP）和颈静脉压（JVP）水平显著高于T0时的水平（P<0.05）。CNG组在T3和T4时的血红蛋白（Hb）水平低于T0时的水平（P<0.05），OG组在T4时的Hb水平低于T1时的水平（P<0.05）。CNG组在T3和T4时的Hb水平低于T1时的水平（P<0.05），OG组在T1和T2时的Hb水平低于CNG组（P<0.05）。简易精神状态检查表（MMSE）认知功能评分低于手术前一天记录的评分（P<0.05）。
腹腔镜根治性前列腺切除术患者采用急性高容量血液稀释可维持其血流动力学稳定，有助于减少输血，改善脑组织氧供以维持供需平衡，并减少对患者认知功能的影响。
