Effect Of Acute Hipervolemic Hemodilution On Perioperative Coagulation Function In Patients Undergoing Spinal Surgery

Objective:To evaluate the effect of AHH on coagulation function in patients undergoing spinal surgery with acute hypervolemic hemodilution at a ratio of 6%hydroxyethyl starch 130/0.4 to sodium lactate Ringer's solution of 1:1.Methods:Forty six patients who underwent elective spinal surgery under general anesthesia,aged 18⁶0years,BMI 18²6 kg/m²,ASA?^?.After the patient entered the room,10 mL/kg sodium lactate Ringer's solution was input to supplement the amount of fluid lost by fasting water.After induction of anesthesia,the rapid transfusion was performed via the internal jugular vein according to the ratio of 6%hydroxyethyl starch 130/0.4 to sodium lactate Ringer's solution to 1:1 Note that the infusion volume is 15mL/kg and the speed is 25mL/min.Blood coagulation function and rapid thromboelastography were measured before AHH?T₀?,30min?T₁?after AHH,and on the first day?T₂?.Record HR,MAP,CVP,urine volume,blood transfusion volume,bleeding volume,total infusion volume.Results:T₀,T₁and T₂ parameters were compared,and the difference in R value,Hb and Hct was statistically significant?P<0.05?.For further comparison between groups,R value,Hb and Hct at T₀ and T₁ the difference between T₁ and T₂ was statistically significant?P<0.05?,and the difference between T₀ and T₂ was not statistically significant?P>0.05?;Hb and Hct showed a decrease and then an increase from before intervention to 30 minutes after intervention,and then to 1 day after intervention The trend of R value from the pre-intervention to 30min after the intervention,and then to the first day after the intervention showed a trend of first increasing and then decreasing.There is no statistically significant difference in the mean comparison of the remaining parameters?P>0.05?;Conclusion:For patients undergoing spinal surgery,AHH was performed according to the ratio of sodium lactate Ringer's solution to 6%hydroxyethyl starch130/0.4 at 1:1 and input at 15 mL/kg.TEG has certain value in the monitoring of coagulation function.