术中大剂量输注贺斯对脑膜瘤患者凝血功能的影响

Effect of infusing with great dosage HAES-Sterile during operation in the blood coagulation of meningioma patients

目的：观察大剂量、长时间输注6％贺斯对脑膜瘤患者凝血功能的影响。方法：随机选择60例美国麻醉医师协会（ASA）Ⅰ-Ⅱ级脑膜瘤患者，人手术室后抽取静脉血作对照（TO），当术中失血量占总血容量的20％-30％时，采用6％贺斯补充血容量，术中失血量占总血容量的30％以上时，采用不同比例浓缩红细胞与6％贺斯快速扩充血容量。分别在输注不同剂量6％贺斯时抽取静脉血监测APTT、PT、TT、PLT、PCT、MPV及PDW等。结果：当输入6％贺斯2000ml时APTT、PT、TT延长（P〈0．05），但均在正常生理范围内；PLT、PCT、MPV等下降，也均在正常生理范围内；HCT下降23．26％（P〈0．01），但HCT〉0．25。麻醉过程中血流动力学平稳，尿量满意。结论：对脑膜瘤患者在有完备的监测、控制手段下大剂量、长时问输注6％贺斯对患者的凝血功能影响轻微。

OBJECTIVE To observe effect of infusing with great dosage 6% HAES - Sterile for a long time in the blood coagulation of meningioma patients. METHODS Randomly selected sixty meningioma patients of ASA Ⅰ -Ⅱ before operation , collected their venous blood to make contrast after entering the operating - room. During the operation , when the blood loss volume reached 20% - 30% of the total blood volume , adopted 6% HAES - Sterile to supply the blood volume ; when the blood loss beyond 30%, chose aniso - ratio concentration erythrocyte and 6% HAES - Sterile to expand the blood volume rapidly. To draw blood to monitor APTT,PT,TT,PLT,PCT,MPV and PDW. RESULTs： When infused 6% HAES - Sterile 2 000 ml, APTT,PT,TT were all prolonged （ P 〈 0.05 ）, PLT, PCT, MPV were descended , but they were all in the normal physio - Coverage. HCT descended 23.26% （P 〈 0.01 ）, but it surpassed 0.25. During anesthesia, the hemodynamics was stable and urine volume was satisfied. CONCLUSION While perfect monitoring and controlling methods are used, there is a slightly effect of infusing great dosage 6% HAES - Sterile for a long time in the blood coagulation function of the meningioma patients.