RESUMO
The aim of this study was to analyze the changes in coagulation in meningioma patients treated with different injections using the method of acute hypervolemic hemodilution (AHH). One hundred fifty hindbrain membrane meningioma patients were randomly divided into 5 groups, 30 per group. The first group were injected 40ml/time with Danhong after anesthesia induction; the second group were injected with 40ml~60ml/time Kangai and combined with interventional chemotherapy and embolization procedure; the third group of AHH were injected with polygeline 15ml/kg; the fourth group were injected with hydroxyethyl starch (130/0.4) sodium chloride in doses of 15ml/kg; the control group underwent basic treatment for lowering blood pressure and lowering blood fat. The changes of coagulation index were recorded before and after surgery and before and after the injection of different medications. Compared to the control group, for the first group of AHH, after being treated for 10 days and 30 days, the concentrations of bone specific alkaline phosphatase (BALP), bone Gla protein (BGP) and pro-collagen carboxy-terminal propeptide (PICP) were higher than that of the control group, the levels of endotoxin (ET) and C-reactive protein (CRP) were decreased compared to the control group (p less than 0.05); for the second group of AHH, after being treated for 10 days, the index of prothrombin time (PT), activated partial thromboplastin time (APTT), thrombin time (TT), fibrinogen (Fg) were not significantly changed, but the related level of vascular endothelial growth factor (VEGF) significantly decreased (p less than 0.05). Comparing the coagulation function index after surgery in the third and fourth groups, there were no significant changes in mean arterial pressure (MAP) level, heart rate (HR) value presented a low decrease, central venous pressure (CVP) level increased and the level of interleukin IL-6 showed a steady state after increasing. Analyzing the levels of interleukin IL-8 and tumor necrosis factor-α (TNF-α) after surgery, it was seen that in the third group they increased and in the fourth group they decreased (p less than 0.05). Danhong injection improved the coagulation function and microcirculation of patients, Kangai injection and interventional chemotherapy and embolization restrained the appearance of tumor angiogenesis, AHH operation with polygeline injection and hydroxyethyl starch (130/0.4) sodium chloride kept blood flow in normal parameters.
Assuntos
Coagulação Sanguínea/efeitos dos fármacos , Cardiotônicos/uso terapêutico , Medicamentos de Ervas Chinesas/uso terapêutico , Hemodiluição/métodos , Neoplasias Meníngeas/tratamento farmacológico , Meningioma/tratamento farmacológico , Adulto , Fosfatase Alcalina/genética , Fosfatase Alcalina/metabolismo , Pressão Arterial/efeitos dos fármacos , Pressão Arterial/fisiologia , Biomarcadores/metabolismo , Viscosidade Sanguínea/efeitos dos fármacos , Proteína C-Reativa/genética , Proteína C-Reativa/metabolismo , Embolização Terapêutica/métodos , Endotoxinas/metabolismo , Feminino , Fibrinogênio/genética , Fibrinogênio/metabolismo , Expressão Gênica , Frequência Cardíaca/efeitos dos fármacos , Frequência Cardíaca/fisiologia , Humanos , Derivados de Hidroxietil Amido/administração & dosagem , Masculino , Neoplasias Meníngeas/sangue , Neoplasias Meníngeas/patologia , Neoplasias Meníngeas/cirurgia , Meningioma/sangue , Meningioma/patologia , Meningioma/cirurgia , Pessoa de Meia-Idade , Osteocalcina/genética , Osteocalcina/metabolismo , Fragmentos de Peptídeos/genética , Fragmentos de Peptídeos/metabolismo , Substitutos do Plasma/administração & dosagem , Poligelina/administração & dosagem , Pró-Colágeno/genética , Pró-Colágeno/metabolismo , Rombencéfalo/efeitos dos fármacos , Rombencéfalo/metabolismo , Rombencéfalo/patologia , Rombencéfalo/cirurgia , Fator A de Crescimento do Endotélio Vascular/genética , Fator A de Crescimento do Endotélio Vascular/metabolismoRESUMO
The aim of this study was to determine if acute perioperative normovolaemic haemodilution with retransfusion of the autologous blood at the end of operation would reduce or eliminate the need for homologous (banked) blood. Forty patients scheduled for total hip prosthesis replacement (THPR) were randomly divided into two groups: Group A, 20 patients from whom 900 ml of blood was taken 20 min preoperatively, the volume being replaced with 1000 ml of gelatin solution (Haemaccel). Group B, 20 patients who were undergoing the same operation but from whom no blood was taken. Both groups were allowed a fall in haematocrit (Hct) to 0.25 before transfusion was started. A standard formula to calculate allowable blood loss plus intraoperative Hct measurements were used to achieve the haemodilution. There was no significant difference in blood loss between the two groups. Transfusion requirement was the same in the two groups. In this study, autotransfusion by the withdrawal of 900 ml of blood is inadequate to reduce the transfusion requirement further than that which can be achieved by haemodilution alone.
Assuntos
Transfusão de Sangue Autóloga , Prótese de Quadril , Adulto , Idoso , Perda Sanguínea Cirúrgica , Transfusão de Sangue , Volume Sanguíneo , Humanos , Pessoa de Meia-Idade , Volume Plasmático , Poligelina/administração & dosagem , Fatores de TempoRESUMO
The effects of volume replacement with 4% gelatin containing 1% glycine at pH 5.8 and 6.4 on the changes in mean arterial blood pressure (MABP) and blood levels of glucose, lactate and urea following acute haemorrhage in dogs were studied. Comparison was made with dogs given homologous blood. Dogs bled 30% of blood volume, maintained in shock for 30 min, and infused with gelatin solutions, showed values of MABP, blood glucose, lactate and urea nitrogen insignificantly different from dogs similarly bled and infused with homologous blood. The responses obtained in dogs infused with gelatin at pH 5.8 were better than at pH 6.4.