关键词: 血液稀释, 凝血功能, 电解质

Abstract:

To compare the changes of coagulation and electrolyte during hypervolemic hemodilution induced by lactated Ringer′s solution(LR), haemaccel(H)or gelofusine(G), 30 neurosurgical patients without heart diseases were randomly allocated into three groups. Hypervolemic hemodilution was induced by rapid infusion, 25 mL/min, in patients of LR(group LR, n=10), H(group H, n=10)or G(group G, n=10)after general anesthesia. Hematocrit(Hct), activate partial thromboplastin time(APTT), prothrombin time(PT)and calcium concentration in serum(Ca²⁺)were tested after anesthesia induction, infusion of 500 mL, infusion of 1 000 mL, infusion of 1 500 mL, and 30 min after hypervolemic hemodilution, respectively. Results: During hypervolemic hemodilution, Hct decreased by 10.8% after 1 500 mL infusion of LR, while APTT, PT and Ca²⁺ did not change significantly in group LR. In group H, Hct decreased by 24.1%, Ca²⁺ increased by 8.3%, APTT and PT did not change significantly after 1 500 mL infusion of H. In group G, Hct and Ca²⁺ decreased by 25.5% and 12.5% respectively, APTT and PT prolonged 21.0% and 14.0% respectively after 1 500 mL infusion of G. The result shows that H and G used for hypervolemic hemodilution are better than LR; H is suitable for the patients with low serum Ca²⁺; and G should not be used for patients with coagulation disorder.

Key words: hypervolemic hemodilution, coagulation, electrolyte