Goldberg M E, Rosenblum H M, Seltzer J L, Rosato F E
Can Anaesth Soc J. 1984 Sep;31(5):552-8. doi: 10.1007/BF03009542.
Isolated regional perfusion for the treatment of malignant melanoma is an accepted method of treatment. No standard of anaesthetic practice has been established for those individuals. Perioperative records of patients undergoing isolated limb perfusion were studied to determine adequate blood replacement. Records were examined and compared for (1) age, (2) ASA physical status, (3) presence of associated disease, (4) anaesthetic technique, (5) the amount of blood and fluid replacement, (6) preoperative haemoglobin (hgb) and haematocrit (hct) and postoperative serial complete blood counts. Fifteen patients were studied (mean age 53 +/- 16 yrs). Mean blood and fluid replacement was: packed red blood cells; 2.28 +/- 0.82 units, 722 +/- 17 ml of 5 per cent albumin, 1747 +/- 21 ml crystalloid. There were twelve Physical Status Class I or II and three Class III patients. All patients received general anaesthesia. There was a statistically significant difference in the preoperative and postoperative values for haemoglobin and haematocrit (p less than 0.01) with no difference between the postoperative and discharge values. Adequate blood replacement was determined by the equation: (Formula: see text) Extensive invasive monitoring is not routinely required for adequate blood replacement or the detection of leaks between the systemic and isolated circulation.
孤立区域灌注治疗恶性黑色素瘤是一种公认的治疗方法。对于这些患者尚未确立麻醉实践标准。对接受孤立肢体灌注的患者围手术期记录进行研究以确定足够的血液补充量。检查并比较记录的内容包括：(1)年龄，(2)美国麻醉医师协会（ASA）身体状况分级，(3)相关疾病的存在情况，(4)麻醉技术，(5)血液和液体补充量，(6)术前血红蛋白（hgb）和血细胞比容（hct）以及术后系列全血细胞计数。研究了15例患者（平均年龄53±16岁）。血液和液体的平均补充量为：浓缩红细胞2.28±0.82单位，5%白蛋白722±17毫升，晶体液1747±21毫升。有12例身体状况分级为I或II级患者以及3例III级患者。所有患者均接受全身麻醉。血红蛋白和血细胞比容的术前和术后值存在统计学显著差异（p<0.01），术后值与出院时的值无差异。足够的血液补充量由以下公式确定：（公式：见原文）对于足够的血液补充或检测体循环与孤立循环之间的渗漏，通常不需要广泛的有创监测。
