Mathieu-Daudé J C, Romieu M, Wintrebert P, du Cailar J
Ann Anesthesiol Fr. 1979;20(9):789-96.
In 18 subjects undergoing aorto-bifemoral by-pass, pre-operative isovalaemic hemodilution was carried out (using a dextran of molecular weight 60,000) at the same time as venous section of a mean value of 1087 ml reducing the hematocrit to 0.30. The following were studied before, immediately after and 24 hours after hemodilution: blood viscosity (at variable shearing rates), oncotic pressure, sedimentation rate, clotting factors, plasma electrolytes. These results showed that at the end of hemodilution, oncotic pressure was maintained and even increased despite the fall in blood protein levels, with also a decrease in blood viscosity, a tendency to dynamic hypocoagulability (thrombocytopenia, fall in fibrinogen and increase in cephalin kaolin time and Quinck time) without any increase in lytic activity. 24 hours later, these parameters tended to return to normal. Discussion on the basis of a study carried out in vitro, seeks to demonstrate which of these changes were related to the dextran molecule and which were related to the hemodilution.
在18例行主-双股动脉旁路移植术的患者中,术前进行了等容血液稀释(使用分子量为60,000的右旋糖酐),同时静脉放血平均1087ml,使血细胞比容降至0.30。在血液稀释前、刚结束时及24小时后,对以下指标进行了研究:血液粘度(在不同剪切速率下)、胶体渗透压、血沉率、凝血因子、血浆电解质。这些结果表明,在血液稀释结束时,尽管血液蛋白水平下降,但胶体渗透压得以维持甚至升高,同时血液粘度降低,出现动态低凝倾向(血小板减少、纤维蛋白原降低以及白陶土部分凝血活酶时间和昆克时间延长),而纤溶活性未增加。24小时后,这些参数趋于恢复正常。基于一项体外研究进行的讨论,旨在证明这些变化中哪些与右旋糖酐分子有关,哪些与血液稀释有关。