羟乙基淀粉对颅脑手术患者血浆胶体渗透压的影响

Effects of Hydroxyethyl Starch on Blood Plasma Colloid Osmotic Pressure in Patients Undergoing Craniotomy

目的观察颅脑手术患者输注羟乙基淀粉130/0.4氯化钠注射液行术前急性高容量血液稀释（AHH）对血浆胶体渗透压（COP）的影响。方法将100例ASA分级Ⅰ~Ⅱ级择期行颅脑手术患者随机分成两组：羟乙基淀粉130/0.4组（V组,n=50）和平衡盐注射液组（R组,n=50）,按组别于麻醉诱导后、手术前分别用相应液体进行AHH,分别于AHH前,AHH后,测定患者的循环指标、血常规、电解质及COP。结果 V组AHH后COP较稀释前明显升高（t=-81.550,P〈0.05）,而R组则较稀释前明显下降（t=29.453,P〈0.05）。结论羟乙基淀粉130/0.4进行AHH可显著提高颅脑手术患者的COP。

Objective To observe the effect of acute hypervolemic hemodilution （ AHH ） with hydroxyethyl starch 130/0.4 and sodium chloride injection on blood plasma colloid osmotic pressure （COP） in patients undergoing craniotomy. Methods 100 ASA Ⅰ -Ⅱ patients undergoing craniotomy were randomly allocated into 2 groups：hydroxyethyl starch 130/0.4 group（ group V, n = 50）and lactated ringer solution group（ group R, n = 50）. The blood pressure （MAP）, heart rate （HR）, blood plasma COP, blood routine test and electrolyte were measured before AHH, and after AHH. Results After AHH, the blood plasma COP of the patients in group V increased significantly than the COP measured before A/-IH （ t = - 81. 550 ,P 〈 O. 05 ）. In the contrary,the blood plasma COP measured after AHH decreased signifi- cantly than that before AHH in group R （ t = 29. 453, P 〈 0.05 ）. Conclusion Hydroxyethyl starch 130/ 0.4 and sodium chloride injection used for AHI-I, increases the blood plasma COP in patients undergoing craniotomy.