贺斯和血定安在乳腺癌根治术中的临床应用研究

Hydroxyethyl Starch and Gelofusine on Hemodynamics and Hemorheology in Patients during Radical Operation of Breast Cancer

目的:通过在乳腺癌根治术中应用贺斯、血定安两种血浆代用品对人的血液动力学及血液流变学的影响的研究,为临床选择理想的血浆代用品提供参考.方法:选择乳腺癌根治术病人18例,ASAI-Ⅱ级,肝肾功能正常,随机分成贺斯组和血定安组,每组9例,分别在术前1h,术后1h,术后24h,术后7天,记录其血液动力学和血液流变学指标并进行比较分析.结果:两组病人术后的血液动力学指标分别与术前值比较均无显著差异,组间比较也无显著差异.术后1h、术后24h、术后7天两组Hb、RBC、HCT由于出血、输入血浆代用品与术前值比较均显著下降(P<0.05).结论:短时间内大量输入血定安或贺斯治疗乳腺癌根治术中的快速、较大量失血是可行的,提示人体对血液稀释具有较强的耐受程度。

Objective: To investigate the effects of two plasma substitutes 6% hydroxyethyl (HAES) starch and Gelofusine on hemodynamics and hemorheology in patients during radical operation of breast cancer. Methods: 18 patients undergoing radical operation for breast cancer, ASA Ⅰ-Ⅱ, renal and hepatic functions normal, were randomly divided into 6% HEAS group (9 cases) and Gelofusine group (9 cases). The parameters of hemodynamics and hemorheology were recorded perioperatively. Perioperative bleeding volume, urine volume, plasma substitutes volume as well as operation time were also recorded. Results: There was no significant difference with regard to the parameters of hemodynamics in both groups. The significant changes on hemorheology (Hb, RBC and HCT) at 1h preoperatively, at 1h, 24h, and 7th day postoperatively were observed (P<0.05). Conclusion: Plasma substitutes could maintain stable hemodynamics and avoid the transfusion of blood as the perioperative bleeding volume was about 1000 ml, suggesting that hemodilution may be tolerated better in all patents undergoing radical operation of breast cancer all patents of both groups.