小儿体外循环预充羟乙基淀粉的临床研究

The clinical research of Hydroxyethyl starch infusion during cardiopulmonary bypass in children

目的探讨6%羟乙基淀粉液对行体外循环术小儿红细胞压积、血浆总蛋白、血浆电解质、血小板计数、激活全血凝固时间、凝血酶原时间及血气分析的影响。方法40例心内直视手术患儿随机分为6%羟乙基淀粉组(VOLVEN组)、血浆组(BP组),每组20例。观察术前、心肺转流15min、返回ICU和术后24h上述指标的变化。结果在心肺转流15min时,VOLVEN组红细胞压积为0.24±0.01和BP组红细胞压积为0.25±0.02,呈中度血液稀释,VOLVEN组血浆总蛋白为(31.4±2.5)g/L和BP组血浆总蛋白为(35.5±2.4)g/L;返回ICU时,VOLVEN组红细胞压积为0.27±0.02和BP组红细胞压积为0.29±0.01,VOLVEN组血浆总蛋白(50.1±2.7)g/L和BP组血浆总蛋白(50.3±2.9)g/L,两组红细胞压积、血浆总蛋白均明显回升(P<0.05);VOLVEN组血小板计数(128.5±21.8)低于BP组(142.0±26.3)(P<0.05),激活全血凝固时间、凝血酶原时间、血浆电解质均在正常范围,血气分析亦显示术后2组无明显变化(P>0.05)。结论采用6%羟乙基淀粉血液稀释用于小儿心内直视手术是较安全有益的方法。

Objective To observe the effects of 6% hydroxyethyl starch infusion during cardiopulmonary bypass on haematocrit,blood plasma total protein,blood plasma electrolyte,platelet count,prothrombin time（PT）, activated whole blood clot time（ACT） and blood gas analysis. Methods 40 case open heart surgical children under cardiopulmonary bypass were randomly divided two group：VOLVEN group were infused with 6% Volven （130/0.4） 400 ml before cardiopulmonary bypass. And Bood plasma group were infused with Bood plasma 400 ml before cardiopulmonary bypass. Every group has 20 case.Observed those index before operation,after bypass 15 min,after ICU,after operation 24 hours. Results After ICU platelet count of group Volven were significantly lower than that of group BP.There were no significant changes inPT、ACT,blood plasma total protein,blood plasma electrolyte,blood gas analysis. Conclusion Hydroxyethyl starch infusion is one safty method during cardiopulmonary bypass.