围术期患者右旋糖酐40急性扩容前后凝血、抗凝、纤溶功能的变化

Influences of Rapid Volume Expansion of Dextran 40 Solution on Coagulant and Anticoagulant Function of Patients During Peri-operational Period

由于大剂量（每24h超过1500m1）持续输注右旋糖酐40溶液对人体凝血功能有显著影响，因而减少了其在临床的应用。但近年来对围术期深静脉血栓和肺栓塞的日益重视，使右旋糖酐40溶液的应用随之增多。其对人体出凝血功能的影响仍是临床关注的重要问题。本研究以常规剂量（1000ml）右旋糖酐40溶液，对围术期患者进行急性扩容，观察其对凝血、抗凝和纤维蛋白溶解功能的影响，

Objective: To observe the influences of rapid volume expansion of Dextran 40 solution(1000ml)on coagulant, anticoagulant and fibrinolytic function of patients during peri-operational period.Method: Select forty ASAⅠ～Ⅱpatients scheduled for abdominal surgery under general anesthesia. When the operations started, Dextran 40 solutions were infused instantly and finished in 2 hours. Collect blood samples from veins at two time intervals, 1 hour before induction of anesthesia and 2 hours after induction of anesthesia,PLT, APTT,PT,Fib,PLG and FVIII:C,AT:A,APC activation were tested.Results: Compared with the datas before infusion,APTT,PT prolong, and the difference had remarkable significance. FVIII:C,AT:A,and PLG were all significantly depressed(P<0.05～0.001).Conclusion: Rapid volume expansion of Dextran 40 solution influence coagulant,anticoagulant and fibrinolytic functions significantly during peri-operational period. It brings the risk of hemorrhage and thrombosis, doctors must pay attention to it.