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目的：观察颅脑肿瘤病人围术期实施急性等容血液稀释后对颅脑手术病人可能产生的影响。方法：随机观察１２例ＡＳＡＩ－Ⅱ级择期颅脑肿瘤切除术患者。麻醉诱导：硫贲妥钠４～８ｍｇ／ｋｇ，万可松０．０８ｍｇ／ｋｇ、芬太尼４～６μｇ／ｋｇ，司可林２ｍｇ／ｋｇ，经口明视下气管插管，接麻醉机，控制呼吸，吸入氧浓度为１００％，经右颈内静脉置入Ｓｗａｎ－Ｇａｎｚ导管，热稀释法测定心排量。按８ｍｌ／ｋｇ体重经右桡动脉穿刺针放血，以同样速度经右肘静脉输入等量的海脉素。监测血液稀释前、后、术毕病人氧供、氧耗、动、静脉血乳酸浓度等指标的变化，数据以均数±标准差表示，用配对ｔ检验，当Ｐ＜０．０５时，认为有意义。结果：平均放血量（４３０±１２０）ｍｌ，病人于围术期中出血量约（８００±１５０）ｍｌ。血液稀释后病人的心脏指数增加了２３％，氧供、氧耗、氧摄取率无显著变化，术毕颈内静脉血乳酸浓度升高，围术期中病人鼻咽温度维持在３５℃左右。结论：急性等容轻度血液稀释（８ｍｌ／ｋｇ）对于颅脑肿瘤病人术前无明显贫血者安全有效，可以减少输入异体血，适度血液稀释及围术期中保持亚低温有利于脑功能的保护。
OBJECTIVE: To observe the possible effect of acute normovolemic hemodilution on patients with craniocerebral trauma during craniotomy. Methods: Twelve patients with ASAI-Ⅱ elective brain tumor resection were randomly selected. Induction of anesthesia: Thiophanate sodium 4 ~ 8mg / kg, million cansone 0.08mg / kg, fentanyl 4 ~ 6μg / kg, Secretary Hill 2mg / kg, , Control breathing, inhaled oxygen concentration of 100%, Swan-Ganz catheter was placed in the right internal jugular vein, cardiac output was measured by thermal dilution method. Press 8ml / kg body weight through the right radial artery puncture needle bleeding at the same speed through the right elbow vein input the same amount of the sea veins. The changes of oxygen supply, oxygen consumption, arterial and venous blood lactate concentrations before and after hemodilution were monitored. The data were expressed as mean ± standard deviation, using paired t-test. When P <0.05, Significant. Results: The average amount of bleeding (430 ± 120) ml, the patient during perioperative blood loss of about (800 ± 150) ml. After hemodilution, the patient’s heart index increased by 23%. There was no significant change in oxygen supply, oxygen consumption and oxygen uptake rate. The blood lactate concentration in the jugular vein increased after operation. The temperature of the nasopharynx in the perioperative period was maintained at about 35 ℃. Conclusions: Acute isovolemic mild hemodilution (8ml / kg) is safe and effective for the patients with brain tumor without preoperative anemia, which can reduce the input of allogeneic blood, moderate hemodilution and protection of mild hypothermia during perioperative period .