摘要
目的观察急性高容量血液稀释(acute hypervolemic hemodilution,AHH)联合自体血回收对骨科手术患者回输自体血红细胞膜钙泵活性的影响。方法 40例择期行骨科手术患者,ASA分级Ⅱ级,采用随机数字表法分为两组,每组20例。A组用6%羟乙基淀粉行急性高容量血液稀释联合术中自体血回输;B组单用术中自体血回输。分别于麻醉前(T1)、手术开始前(T2)、洗涤前(T3)、洗涤后(T4)各采血2mL。采用单波长激发指示剂法测定红细胞内游离钙离子浓度,用改良的Fiske-Subbarow法测定红细胞Ca2+-Mg2+-ATP酶活性。结果与麻醉前(T1)比较,洗涤前、后(T3、T4)两组红细胞内钙离子内流均明显增加(均P<0.05),红细胞膜Ca2+-Mg2+-ATP酶活性则明显降低(均P<0.05);与B组比较,A组于T3、T4时红细胞内钙离子浓度明显降低(均P<0.05),红细胞膜Ca2+-Mg2+-ATP酶活性则明显增高(均P<0.05)。结论术前采用急性高容量血液稀释能有效维持循环,减轻自体回收血红细胞膜损伤。
Objective To evaluate the effect of acute hypervolemic hemodilution（AHH）combined with autologous transfusion on calcium pump activity of red cell membrane in patients subject to orthopedic surgery.Methods Forty patients who would undergo orthopedic surgery,with their age ranging from 30 to 65 years,and their ASA grade being ASA Ⅱ,were randomly divided into two groups（n=20 each）.In group A,patients were given AHH（by using 6% hydroxyethyl starch）plus autologous transfusion and those in group B were given autologous transfusion alone.The Ca2＋-Mg2＋-ATPase activity on the erythrocyte membrane and the intracellular calcium content of erythrocytes were measured by using modified Fiske-Subbarow method and single wavelength excitation respectively before anesthesia（T1）,before operation（T2）,before washing（T3）and after washing（T4）.Results The intracellular calcium content of erythrocytes was significantly increased and the activity of Ca2＋-Mg2＋-ATPase was significantly decreased in both groups at T3and T4when compared with those at T1（P〈0.05）.However,the intracellular calcium content of erythrocytes was significantly lower and the activity of Ca2＋-Mg2＋-ATPase significantly greater in group A than those in group B at T3and T4（P〈0.05）.Conclusion AHH and autologous blood transfusion can effectively maintain blood circulation and alleviate the damage of erythrocyte membranes in autologous blood transfusion.
出处
《华中科技大学学报（医学版）》
CAS
CSCD
北大核心
2013年第3期324-326,共3页
Acta Medicinae Universitatis Scientiae et Technologiae Huazhong
关键词
急性高容量血液稀释
自体输血
血液回收
细胞内钙离子浓度
acute hypervolemic hemodilution
blood transufusion
blood salvage
intracellular calcium content
