摘要
目的观察6%羟乙基淀粉130/0.4（万汶）急性高容量血液稀释对凝血功能的影响。方法择期骨科手术患者60例,ASAⅠ-Ⅱ级,年龄18-60岁,随机分为2组,每组30例,入室后于麻醉诱导前以30 ml/min的速度分别输入6%羟乙基淀粉200/0.5（贺斯）或万汶20 ml/kg。测定稀释前（t1）、稀释完成（t2）、稀释后15 min（t3）的MAP、HR、CVP。t1、t3均测定血常规及血栓弹力描记图（TEG）各指标。结果与t1比较,两组患者t2、t3的CVP和MAP均显著升高（P〈0.01）;t3两组HR均升高（P〈0.05）,Hb、HCT、PLT、MA均下降（P〈0.05）,贺斯组TEG的K时间延长,α角减少（P〈0.05）。与贺斯组比较,万汶组t3PLT升高（P〈0.05）。结论万汶与贺斯具有相似的扩容效果,但万汶对患者凝血功能的抑制程度比贺斯小。
Objective To evaluate the effect of acute hypervolemie hemodilution （ AHHD ） with hydroxyethyl stareh（HES 130/0. 4）on blood coagulation. Methods Sixty ASA Ⅰ - Ⅱ adult patients undergoing orthopedic surgery were entered in the double-blind study. The patients were randomized to receive 20 ml/kg of either HES 200/0. 5 or HES 130/0. 4 in 30 ml/min before induction. MAP,HR and CVP were recorded before AHHD （ t1 ）, at the end of AHHD （ t2 ） and 15 minutes after AHHD （ t3 ）. Venous blood samples were taken at h and t3 for determination of Hb, HCT, PLT and thromboelaseograthy （TEG）. Results Comparing with the value of h ,CVP and MAP were increased at t2 and t3（P 〈0. 01 ）. HR was increased and Hb,HCT,PLT,MA were decreased in both groups at t3 （ P 〈 0. 05 ）. At the same time, K time was prolonged and angle α was decreased in group HES 200/0. 5 （ P 〈 0. 05 ）. PLT in group HES 130/0.4 was higher than in group HES 200/0. 5 at t3 （ P 〈 0. 05）. Conclusion HES 130/0. 4 has same effect on blood volume expansion comparing with HES 200/ 0. 5. HES 130/0.4 compromises the coagulation function less than HES 200/0. 5.
出处
《中国实用医药》
2008年第24期20-21,共2页
China Practical Medicine
