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[术中机械性自体输血]

[Mechanical intraoperative autotransfusion].

作者信息

Homann B

出版信息

Fortschr Med. 1983 Jun 16;101(23):1097-102.

PMID:6884941
Abstract

The cardiac effects during maximum pressure autotransfusion of blood which was anticoagulated by different methods, were studied in 2 series of 9 dogs. The animals, which were anaesthetized and splenectomized, received each 300 i.v. heparin/kg bodyweight intravenously before being subjected to repeated maximum pressure auto-transfusions of 10% of their whole blood volume. The anticoagulant employed during each autotransfusion was changed in station as follows: Heparin-(ACD-B)-Citrate-Heparin-CPD-Citrate... and so on. Criteria of cardiac efficiency, signs of insufficiency, pumpfunction (force of contraction, contractility) were all derived from the 4 phases of the aortic pressure tracing. In addition various parameters of the ECG, using the "Colletti distances", were measured. The results were proved by laboratory data. Immediately after the pre-determined bleeding (V) there was a characteristic fall of all parameters corresponding to the acute reduction in circulating blood volume, which returned to normal after the autotransfusion was completed (G). During the transitory phase S all data remained stable when heparin had been employed as the anticoagulant. Following the use of citrate, however, particularly CPD, there was an ensuing fall in all accounted for by the acute withdrawal of Ca++ which could be measured. Subsequently the circulation stabilized (ST) spontaneously and all parameters being measured returned to their original values when heparin and ACD-B had been used. With CPD, however, the force of contraction, enddiastolic pressures and propagation of electric activity of the heart were still altered.

摘要

在两组共9只犬中研究了采用不同方法抗凝的血液在最大压力自体输血过程中的心脏效应。这些动物经麻醉和脾切除,在对其进行相当于全血容量10%的重复最大压力自体输血之前,每只静脉注射300单位/千克体重的肝素。每次自体输血时使用的抗凝剂按顺序改变如下:肝素-(ACD-B)-枸橼酸盐-肝素-CPD-枸橼酸盐……依此类推。心脏效率标准、功能不全体征、泵功能(收缩力、收缩性)均从主动脉压力曲线的4个阶段得出。此外,使用“科莱蒂距离”测量了心电图的各种参数。结果得到实验室数据的证实。在预定放血(V)后,所有参数立即出现特征性下降,这与循环血量的急性减少相对应,在自体输血完成后(G)恢复正常。在使用肝素作为抗凝剂的过渡阶段S,所有数据保持稳定。然而,在使用枸橼酸盐,尤其是CPD后,所有参数随后下降,这是由于可测量的Ca++急性减少所致。随后循环自发稳定(ST),当使用肝素和ACD-B时,所有测量参数恢复到原始值。然而,使用CPD时,收缩力、舒张末期压力和心脏电活动的传播仍发生改变。

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