麻醉前应用羟乙基淀粉与复方乳酸钠进行预扩容的对比研究

Comparative Study of Pre-anesthetic Hydroxyethyl Starch and Lactated Ringer's Solution Hypervolemic Hemodilution

目的观察羟乙基淀粉与复方乳酸钠在腰麻硬膜外联合阻滞(CSEA)前进行预扩容的效果和安全性。方法50例行择期剖宫产术的病人随机分为羟乙基淀粉组(H组)和复方乳酸钠组(L组),每组25例。麻醉前按15ml·kg-1·h-1的速度分别输入6%羟乙基淀粉注射液(H组)和复方乳酸钠注射液(L组)。术中连续监测平均动脉压(MAP)、心率(HR)、氧饱和度(SpO2 ),分别于扩容前、扩容后测定Hct、Hb、pH变化。结果L组麻醉后MAP和HR较麻醉前明显下降(P<0. 05),H组的血流动力学稳定。H组的Hct、Hb、pH在扩容后明显低于扩容前(P<0. 01)。结论羟乙基淀粉较复方乳酸钠更能安全有效地使围麻醉期病人保持循环稳定。

Objective To evaluate the safeness and effect of hydroxyethyl starch or lactated Ringer's solution hypervolemic hemodilution before CSEA.Methods Fifty patients undergoing cesarean section were randomly allocated into two groups: group hydroxyethyl starch ( group H) and group lactated Ringer's solution (group L).Each group involving 25 patients. The patients were infused 6% hydroxyethyl starch( group H) or lactated Ringer's solution(group H) at a rate of 15ml·kg -1·h -1. Interoperative observed parameters include: MAP,HR and SpO 2. Blood samples were collected before and after hemodilution for measuring the changes of Hct,Hb and pH. Results In the group L there was a significant decrease in MAP and HR after anesthesia comparing group H (P<0.05).A significant decrease in Hb and Hct was observed in group H after hemodilution comparing group L (P<0.01). pH value also significantly decreased after dilution in group H (P<0.01). Conclusion Pre-anesthetic hydroxyethyl starch hypervolemic hemodilution has more beneficial effects than lactated Ringer's solution on hemodynamics