6%羟乙基淀粉在婴儿腹腔镜手术中容量治疗的临床应用

Use of hydroxyethyl starch 130/0.4 in volume therapy in infants undergoing laparoscopic surgery

目的评价6％羟乙基淀粉130／0．4（6％Voluven，商品名万汶）在婴儿腹腔镜手术中容量治疗的临床应用。方法选择行腹腔镜择期手术婴儿50冽，ASAⅠ～Ⅱ级，随机平均分为两组：使用万汶（试验组）和未使用万汶（对照组）各25例。分析试验组和对照组患儿术中输注液体的差异，比较两组患儿容量治疗前后血流动力学的变化，比较两组患儿术中使用血液制品的比例。结果两组患者容量治疗前后心率、平均动脉压差异无统计学意义；试验组中心静脉压基本稳定而对照组明显下降（P〈0．05）；试验组有7例（7／25，28％），对照组有14例（14／25，56％）术中使用血液制品，差异有统计学意义（P〈0．05）；试验组未见与万汶相关的不良反应或外科并发症。结论万汶用于婴儿腹腔镜手术中容量治疗安全、有效，并显著减少手术中血液制品的使用。

Objective To evaluate the efficacy and safety of 6% hydroxyethyl starch 130/0. 4（6% Voluven） in volume therapy in infants undergoing laparoscopic surgery. Methods Twenty-five cases of infants undergoing laparoseopic surgery, which had been administered Voluven for volume therapy during operations, were enrolled into test group. Another well matched 25 cases of infants, who had not been infused Voluven during the operations,were grouped into control group. The hemodynamic variables,the crystalloid, colloid and blood products volumes, as well as the percentage of patients needs transfusion during operations were compared between the groups. Results No significant difference in the heart and blood pressure was found between the groups. The central venous pressure in the test group was stable but it was significantly falling in the control group,P 〈0. 05. Seven cases （7/25,28%） in the test group,signifieantly less than 14 cases （ 14/25,56% ） in the control group,used blood products during the operations,P 〈 0.05. No Voluven related adverse effects or surgical conlplications were noted in the test group. Conclusion Voluven ean be used safely and efficiently for volunle replacement in infants undergoing laparoscopic surgery, and may decrease the percentage of tile patients who need blood products during the operations.