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目的 探讨术前急性高容量血液稀释(AHH)用于子宫广泛切除术围手术期血色素(HB),血球压积(Het),及电解质变化的影响.方法 将46例经病理切片确诊为子宫颈癌患者作为研究对象,术前20 min开始输入乳酸钠林格氏液(15 mL/kg,50 ml/min),于稀释前、AHH后(切皮前)、手术结束分别抽取输液对侧贵要静脉血.使用I-STAT血气分析仪,EC8+试剂片测定HB、Hct、Na、K、CL值.结果 稀释后、手术结束后与稀释前比较Hb、Het差异有显著性(P＜0.05),但手术结束后与稀释后比较则无显著性差异(P＞0.05).而电解质除K在手术后与稀释前、稀释后比较差异有显著性外(P＜0.05),余无显著性差异(P＞0.05).结论 术前急性高容量血液稀释用于子宫颈癌行子宫广泛切除术术可保持HB、Hot在正常范围而对血电解质浓度无影响,可避免异体输血导致血源性传播疾病,是一种有效、简便的方法.

Objective To evaluate the preoperative acute hypervolemic hemodilution (AHH)for wide excision of uterine perioperative hemoglobin(HB),hematocrit (Het),and electrolyte changes.Methods 46 cases with pathologically diagnosed with cervical cancer biopsy,as object of study,preoperative 20 min start typing lactated ringer' s solution( 15 ml/kg,50 ml/min).In pre-dilution,AHH after( before skin incision),taking the end of surgery the contralateral basilic vein blood transfusion.Using the I-STAT blood gas analyzer,EC8 + reagent tablets determination of HB,Hct,Na,K,CL values.Results The diluted the end of surgery after dilution earlier Hb,Het difference was significant(P ＜ 0.05 ).However,after the end of surgery compared with diluted no significant difference( P ＞ 0.05 ).In addition to K in the hand and the electrolyte patients with pre-diluted and diluted there was significant difference between the outer ( P ＜ 0.05 ),I was no significant difference between(P ＞ 0.05).Conclusion Preoperative acute hypervolemic hemodilution in uterine cervical cancer,wide excision surgery can maintain HB,Hct in the normal range but had no effect on blood electrolyte concentration can avoid allogeneic blood transfusion led to blood-borne transmitted diseases,is an effective,easy way.