国产聚明胶肽作为心肺转流胶体预充液的安全性和对血液流变学的影响

Safety and hemorheology effects of Chinese polygeline as priming fluid in cardiopulmonary bypass

目的研究国产聚明胶肽注射液与羟乙基淀粉130/0.4氯化钠注射液作为心肺转流(CPB)胶体预充液的安全性和对血液流变学的影响。方法择期CPB手术患者60例随机分为两组:A组(n=29)预充国产聚明胶肽1 000 ml和复方乳酸钠;B组(n=31)预充羟乙基淀粉130/0.4氯化钠注射液1 000 ml和复方乳酸钠。分别于CPB前、CPB开始后10 min和复跳后测定血浆渗透压及血钾、钠、镁、钙浓度;观察CPB中尿量及术后1 d晨尿量;检测CPB前、CPB中及术后2 h血液流变学参数等。结果 (1)CPB中A组的尿量明显多于B组;CPB前、CPB开始后10 min和复跳后血浆胶体渗透压及血钾、钠、镁和钙离子浓度各时点差异均无统计学意义。(2)两组患者的清醒及拔管时间、次日晨胸腔引流量、血压、氧分压、术后库血及血浆使用量差异无统计学意义。(3)两组患者全血黏度1.0、30、180,还原黏度1.0、30、180,Hct、刚性指数、聚集指数及变形指数在各时点差异均无统计学意义。结论国产聚明胶肽与羟乙基淀粉130/0.4氯化钠注射液作为CPB胶体预充液的临床效果基本一致。

Objective To compare the clinical safety and hemorheology effects of Chinese polygeline with hydroxyethyl starch130/0.4 as the priming fluid in cardiopulmonary bypass（CPB）.Methods Sixty adult patients underwent selective cardiac surgery under CPB were randomized into two groups.The priming fluid in experiment group was Chinese polygeline 1000 ml and lactated Ringer＇s solution and that in control group was hydroxyethyl starch130/0.4 1000 ml and lactated Ringer＇s solution.Results The urine output in experiment group was more than that in control group during CPB.Osmotic pressure and the concentrations of K＋,Na＋,Ca2＋ and Mg2＋had no significant difference between two groups before CPB,at 10 min after and heart rebeating.There were no significant differences between two groups in the times of wakeup and extubation,and blood pressure,oxygen partial pressure,thoracic drainage volume in the next morning as well as the postoperative use of blood and plasma.There was no significant difference in the whole blood viscosity 1.0,30,80,deoxidized viscosity 1.0,30,180,Hct,rigidity index,conglomeration index,and distortion index at each time.Conclusion Chinese polygeline as the priming colloid fluid for CPB has the same clinical effects as hydroxyethyl starch130/0.4.