摘要: 目的: 探讨急性超容血液稀释(AHHD)对电解质的影响。方法: 选择32例ASAⅠ~Ⅱ级全麻下择期行耳鼻喉科手术的患者，随机分为稀释组(n=16)和对照组(n=16)。全麻后施行急性超容血液稀释，使红细胞压积(Hct)下降至26.7%，以达到中等程度血液稀释状态。于AHHD前、AHHD后、手术结束时测定红细胞压积(Hct)、血红蛋白(Hb)、肝肾功能、凝血功能及电解质。结果: AHHD后Hct及Hb较AHHD前显著降低，Hct由(39.6±5.1)%下降至(26.7±3.2)%，Hb由(138.4±19.5)g/L下降至(90.7±10.8)g/L，分别下降了32.6%和34.5%。AHHD后血K+由AHHD前(3.9±0.3)mmol/L下降至(3.6±0.3)mmol/L，下降了7.7%； AHHD后血Ca2+(2.3±0.1)mmol/L较AHHD前(1.2±0.0)mmol/L明显降低，下降了47.8%。结论: 急性超容血液稀释后钾离子及钙离子浓度明显降低，影响麻醉中使用的肌肉松弛剂的药效动力学，使肌肉松弛剂起效时间缩短，肌松作用增强。

     关键词: 急性超容血液稀释；电解质；肌肉松弛剂

    The effect of acute hypervolemic hemodilution on electrolytes

    XUAN Fei, ZHENG Hong

    (Department of Anesthesiology, First Affiliated Hospital, Xinjiang Medical University, Urumqi 830054, China)

    Abstract: Objective: To investigate the effect of AHHD on electrolytes. Methods: Thirty two patients, ASAⅠ～Ⅱ, scheduled for otolaryngologic surgery, were divided into two groups randomly (AHHD group and control group). AHHD was performed after general anesthesia. Hct was decreased to 26.7%. Arterial blood samples were taken for determination of Hct, Hb, liver function, kidney function, electrolytes before and after AHHD, and at the end of the surgery. Results: Hct and Hb were significantly decreased after AHHD. Hct decreased from (39.6±5.1)% (before AHHD) to(26.7±3.2)% (after AHHD). Hb decreased from (138.4±19.5)g/L (before AHHD) to (90.7±10.8)g/L (after AHHD).Hct and Hb descended by 32.6% and 34.5%, respectively. K+ decreased from (3.9±0.3)mmol/L (before AHHD) to (3.6±0.3)mmol/L (after AHHD). Ca2+ decreased from (2.3±0.1)mmol/L (before AHHD) to (1.2±0.0)mmol/L (after AHHD). K+ and Ca2+ after AHHD were significantly lower than those before AHHD, descended by 7.7% and 47.8%, respectively. Conclusion: Concentrations of K+ and Ca2+ decrease significantly after AHHD. This will influence pharmacodynamics of muscle relaxants used in anesthesia, decrease the onset time, increase the potency. ......