急性高容量血液稀释联合控制性降压在上矢状窦破裂修补术中的应用

目的：探讨急性高容量血液稀释(AHH)联合控制性降压(CH)用于上矢状窦破裂修补术的临床效果.方法：将22例ASA Ⅱ～Ⅲ级在全麻下行上矢状窦破裂修补术患者随机分成2组(I组：AHH+CH,Ⅱ组：AHH),均于打开骨瓣前行AHH,I组同时用硝普钠行CH.记录AHH前(T0)、骨瓣打开时(T1)、骨瓣打开后10 min (T2)、上矢状窦修复完毕(T3)和术毕(T4)的MAP,HR,Hb,Hct和血气值,计算2组的出血量、输血量、尿量、总输液量及AHH扩容量.结果：2组的CVP值在T1时均较T0明显升高,在T2和T3时I组的与T0比较无显著变化,Ⅱ组的明显低于T0时和I组同时点;在T1时I组的Hct值显著低于Ⅱ组;I组较Ⅱ组扩容量显著增大,输血量明显减少.结论：AHH+CH用于上矢状窦破裂修补术可增加扩容量,增强术中血流动力学的稳定,减少输血量.     

Effects of exchange transfusion with perfluorochemical emulsions on hepatic oxygen supply and blood flow in the rat

Summary Exchange-transfusion to hematocrit 20 with isotonic perfluorochemical (PFC) emulsions containing 3% hydroxyethylstarch (HES) in rats breathing 100% oxygen produced significant reductions of hepatic PO₂ and blood flow in comparison to rats hemodiluted with isotonic 3% or 6% HES solution. The results indicate that PFC and/or emulsifiers were associated with adverse effects on liver blood supply.This work was supported by a grant from the Kentucky Affiliate of the American Heart Association.     

血液稀释治疗急性缺血性肾功能衰竭的实验研究

将一例肾切除.另侧肾夹闭肾动、静脉和输尿管2小时造成急性缺血性肾功能衰竭的18只家兔随机平分三组。第Ⅰ组不加治疗,用作对照;第Ⅱ组用低分子右旋糖酐作等容量血液稀释;第Ⅲ组用GBK 液作二倍容量血液稀释。三组动物在同等条件下饲养,观察、比较其血尿素氮含量,无尿时间,尿量变化,存活时间和死后肾组织学改变。结果显示血液稀释有降低急性缺血性肾功能衰竭动物血中尿素氮,缩短动物无尿时间,提高动物存活率和减轻肾缺血造成的肾损害等作用。     

The effect of moderate hemodilution with Fluosol-DA or normal saline on acetaminophen disposition in the rat

Summary Hemodilution with 40 ml/kg of Fluosol or saline reduced the acetaminophen V_d and the acetaminophen sulfate Cl_M at 48 or 72 h, respectively. Fluosol hemodilution increased the acetaminophen renal excretion at 24 and 72 h. But at 48 h, Fluosol hemodilution either inhibited the renal secretion of acetaminophen or enhanced its reabsorption.