Abstract:【Objective】To investigate the value of controlled hypotension, acute hypervolemic hemodilution (AHH) and retrieved autotransfusion in intracranial tumors surgery.【Methods】The clinical data of 82 patients with intracranial tumors admitted to our hospital from January 2016 to January 2018 were retrospectively analyzed. They were divided into observation group (controlled hypotension + AHH + recycled autotransfusion, n=43) and control group (controlled hypotension + AHH,n=39). The indexes of heart rate (HR), mean arterial pressure (MAP), central venous pressure (CVP) were observed immediately before AHH (T0), 30 minutes after AHH (T1), 60 minutes after AHH (T2) and at the end of operation (T3). 【Results】There was no significant difference in operation time and bleeding volume between the two groups (P>0.05); the proportion of non-transfused blood in the observation group was significantly higher than that in the control group (P<0.05). The MAP at T1 and T2 in the observation group and the control group was significantly higher than that at T0, and the CVP at T1 and T2 in the observation group was significantly higher than that in the control group (P<0.05). Postoperative fibrinogen (FIB) was lower in the two groups than that before operation, while prothrombin time (PT) and activated partial thrombin time (APTT) were significantly higher than those before operation (all P<0.05); there was no significant difference in FIB, PT and APTT between the observation group and the control group before and after operation (P>0.05). 【Conclusion】Controlled hypotension combined with AHH and recycled autologous blood transfusion have better application value in intracranial tumors surgery. It can reduce the situation of allogeneic blood transfusion and has little effect on hemodynamics and coagulation function.
[1] 胥亮,连铁,高瑞君,等.急性等容稀释式自体输血在基层医院手术中的应用[J].广东医学,2016,37(s1):43-45. [2] 方萌,夏中元,雷少青,等.自体输血在基层医院神经外科手术中应用的临床分析[J].中国医师进修杂志,2016,39(8):738-741. [3] 孟宗霞,成杰,高平,等.自体血液回收在急症手术与择期手术中的应用效果比较[J].河北医药,2010,32(14):1859-1860. [4] Sanctis VD,Elsedfy H,Soliman AT,et al.Acquired hypogonadotropic hypogonadism (AHH) in thalassaemia major patients: an underdiagnosed condition [J] ?Mediter J Hematol Inf Dis,2016,8(1):e2016001. [5] Besir A,Cekic B,Kutanis D,et al.Comparison of surgical conditions in 2 different anesthesia techniques of esmolol-induced controlled hypotension in breast reduction surgery:[J].Medicine,2017,96(10):e6254. [6] 卢明军,郭建荣.血液稀释对机体代谢影响的临床应用研究进展[J].山西医药杂志,2017,46(7):773-775. [7] Johnson M A,Williams T K,Ferencz S E,et al.The Effect of REBOA,Partial Aortic Occlusion and Aggressive Blood Transfusion on Traumatic Brain Injury in a Swine Polytrauma Model[J].J Trauma Acute Care Surg,2017,83(1):1. [8] 张晓钢,黄仕斌.急性等容性血液稀释自体输血联合控制性降压在骨科大手术中的应用[J].广西医学,2017,39(7):1095-1097.