摘要Objective To observe the effects of acute normovolemie hemodilution (ANH) on coagulation func-tion and fibrinolysis in elderly patients undergoing hepatic carcinectomy.Methods Thirty elderly patients (aged 60-70 years) with liver cancer (American Society of Anesthe-siologists physical status Ⅰ-Ⅱ) scheduled for hepatic carcinectomy from February 2007 to February 2008 were randomly divided into ANH group (n= 15) and control group (n= 15). After tracheal intubation, patients in ANH group and control group were infused with 6% hydroxyethyl starch (HES) (130/0.4), and basic liquid containing 6% HES and routine Ringer's solution, respectively. In all the studied patients, blood samples were drawn at five different time points: before anesthesia induction (T1), 30 minutes after ANH (T2), I hour after start of operation (T3), immediately after operation (T4), and 24 hours after operation (T5). Then co-agulation function, soluble fibrin monomer complex (SFMC), prothrombin fragment (F1+2), and platelet membrane glycoprotein (activated GPIIb/GPIIIa and P-selectin) were measured.Results The perioperative blood loss was not significantly different between the two groups (P> 0.05). The volume of allogeneic blood transfusion in ANH group was significantly smaller than that in control group (350.5±70.7 mL vs. 457.8±181.3 mL, P<0.01). Compared with the data of T1, prothrombin time (PT) and activated partial thromboplastin time in both groups prolonged significantly after T3 (P<0.05), but still within normal range. There were no significant changes in thrombin time and D-dimer between the two groups and between different time points in each group (all P>0.05). SFMC and F1 +2 increased in both groups, but without statistical significance. P-selectin expression on the platelet surface of ANH group was significantly low-ered at T2 and T3 compared with the level at T1 (P< 0.05). Compared with control group, P-selectin was sig-nificandy lower in ANH group at T2-T5 (all P<0.05).Conclusions In elderly patients undergoing resection of liver cancer, ANH may not hamper fibri-nolysis and coagulation function. It could therefore be safe to largely reduce allogeneic blood transfusion.