Messmer K
Ann Anesthesiol Fr. 1979;20(9):829-32.
In general surgery, routine thromboprophylaxis is strongly recommended in order to reduce the risk of thrombo-embolic complications. If pre-operative hemodilution is used in order to avoid the risks of transfusions of homologous blood, dextran must be used as the diluent. Patients undergoing total hip replacement represent a very high risk group where infusion of dextran is superior to low doses of heparin, but pre-operative hemodilution using dextran is more effective than infusions of dextran. It may thus be concluded that pre-operative hemodilution with dextran would give similar improved results in general surgery. As with all thromboprophylactic agents, side-effects may occur. However, with dextran 60, anaphylactoid reactions have note been described up to the present time in patients undergoing hemodilution before operation.
在普通外科手术中,强烈建议进行常规血栓预防,以降低血栓栓塞并发症的风险。如果采用术前血液稀释以避免输注同源血的风险,则必须使用右旋糖酐作为稀释剂。接受全髋关节置换术的患者是高危人群,输注右旋糖酐优于低剂量肝素,但术前使用右旋糖酐进行血液稀释比输注右旋糖酐更有效。因此可以得出结论,在普通外科手术中,术前用右旋糖酐进行血液稀释可能会取得类似的改善效果。与所有血栓预防药物一样,可能会出现副作用。然而,对于60右旋糖酐,目前尚未有在术前进行血液稀释的患者中发生类过敏反应的报道。