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[术中自体输血、技术管理及其对血液循环、肾脏和电解质的影响(作者译)]

[Intraoperative autotransfusion, technical management and its influence on blood circulation, on kidney and electrolytes (author's transl)].

作者信息

Homann B, Klaue P

出版信息

Anaesthesist. 1977 Nov;26(11):593-9.

PMID:596607
Abstract

From February 1975 until July 1976 12 patients who elective surgery and 15 trauma victims received intraoperative autotransfusion. The effects of this method on these patients were controlled by monitoring the behaviour of circulation and of important laboratory parameters. The procedure was well tolerated: 1. Only three of 29 patients showed evidence of cardiac insufficiency (lowering of ST. elevated T-peak, low blood pressure, high central venous pressure) which disappeared after reducing the rate of infusion. --2. Blood pressure, pulse rate and central venous pressure were stable at the end of the operation. --3. There was no renal insufficiency under dopamine (210 microgram/min) and 15% manitol (250 ml i.v.). --4. Serum creatine showed only minor changes from the initial level during the time of observation. --5. The same was true for beta2-microglobulin. --6. Serum urea rose slightly during 7 days. --7. There were minor changes of electrolytes without hypocalcaemia or high potassium. --8. The observed changes showed no relation to the method of anticoagulation and to time or volume of autotransfusion.

摘要

1975年2月至1976年7月,12例行择期手术的患者和15名创伤患者接受了术中自体输血。通过监测循环系统的表现和重要实验室参数来控制该方法对这些患者的影响。该操作耐受性良好:1. 29例患者中只有3例出现心脏功能不全的迹象(ST段压低、T波峰升高、低血压、中心静脉压升高),在降低输注速度后消失。——2. 手术结束时血压、脉搏率和中心静脉压稳定。——3. 在多巴胺(210微克/分钟)和15%甘露醇(静脉注射250毫升)治疗下未出现肾功能不全。——4. 在观察期间,血清肌酐与初始水平相比仅有轻微变化。——5. β2-微球蛋白也是如此。——6. 血清尿素在7天内略有升高。——7. 电解质有轻微变化,但无低钙血症或高钾血症。——8. 观察到的变化与抗凝方法、自体输血的时间或量无关。

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