The effect of AHH on coagulation function and visceral perfusion in elderly patients undergoing hip replacement
10.3969/j.issn.1673-9701.2024.19.014
- VernacularTitle:AHH程度对老年髋关节置换术中凝血功能、内脏灌注的影响
- Author:
Xiaoge WU
1
;
Yuanliang CHEN
Author Information
1. 金华市中心医院麻醉科,浙江金华 321000
- Keywords:
Hip replacement;
Acute hypervolemic hemodilution;
Coagulation function;
Visceral perfusion
- From:
China Modern Doctor
2024;62(19):66-70
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the effects of acute hypervolemic hemodilution(AHH)on coagulation function and visceral perfusion in elderly patients undergoing hip replacement.Methods A retrospective study was conducted on 102 elderly patients who underwent hip replacement in Jinhua Municipal Central Hospital from January 2021 to June 2023.All patients were treated with AHH,autologous blood transfusion and controlled hypotension,and were divided into group A(n=55)and group B(n=47)according to the degree of AHH.The target dilution value was 30％hematocrit(HCT)for group A and 25％HCT for group B.The general data,urine volume,total infusion volume,blood loss,and heart rate,body temperature,prothrombin time(PT),fibrinogen(FIB),activated partial thromboplastin time(APTT),platelet(PLT)and gastric intramucosal carbon dioxide tension(PgCO2),gastric intramucosal pH(pHi)after anesthesia induction(T0),hemodilution(T1)and postoperative(T2)were compared between two groups.Results The total amount of expanded liquid and infusion in group B was higher than that in group A(P＜0.05).The heart rate and body temperature of T1 in two groups were lower than those of T0 and T2,and heart rate of T1 in group B was lower than that in group A(P＜0.05).The PT of T1 and T2 was longer than that of T0,FIB and PLT were lower than those of T0(P＜0.05).PLT of T1 and T2 in group B was lower than that in group A(P＜0.05).PgCO2 of T1 and T2 in two groups was higher than that of T0,pHi was lower than that of T0(P＜0.05),and pHi of T,and T2 in group B was significantly lower than that in group A(P＜0.05).Conclusion The overall safety of AHH is high when the target value is 25％to 30％of HCT.When the target value is 25％of HCT,PLT level is lower,but it is also in the normal range,while PgCO2 is increased,pHi is decreased.
