不同胶体液在体外循环中对心脏手术患儿胶体渗透压及凝血功能的影响

Effect of different colloids on Colloid Osmotic Pressure and Blood Coagulation of Children during Cardiopulmonary Bypass

目的比较体外循环（CPB）中6%羟乙基淀粉（130/0.4,万汶）和琥珀明胶对心脏手术患儿胶体渗透压和凝血功能的影响。方法选择510岁美国麻醉医师协会（ASA）ⅠⅡ级、行心内直视手术患儿40例,随机分为观察组（万汶组）和对照组（琥珀明胶组）各20例,测定CPB前血液预充液、CPB 10 min、30 min、CPB结束时的胶体渗透压（COP）,凝血功能指标血小板计数（Plt）、凝血酶原时间（PT）、激活全血凝固时间（ACT）。结果对照组CPB中COP明显降低,且低于观察组（P〈0.01）,PT、ACT无明显性延长。结论万汶对小儿凝血功能影响不显著,可安全应用于小儿CPB预充液中。

OBJECTIVE To compare the effect of 6% hydroxyethyl starch solution and succinylated gelatin on colloid osmotic pressure and blood coagulation during cardiopulmonary bypass.METHODS According to Medical Association American Society of Anesthesiologists（ASA） Ⅰ Ⅱ grade,the 40 open hear surgery pediatric cases were randomly divided into observation group and control group,20 cases of each group.The colloid osmotic pressure（COP）,clotting function of platelet count（PLT）,prothrombin time（PT） and activated clotting time（ACT） were measured at the blood priming solution before CPB,10min and 30min after starting CPB,and the end of CPB.RESULTS Compared to observation,the colloid osmotic pressure was significantly decreased in the control group（P〈0.01）.There was no significant increase in PT and ACT value between two groups.CONCLUSION 6% hydroxyethyl starch solution has no significant impact on the blood coagulation and can add into priming solution in pediatric cardiopulmonary bypass safely.