羟乙基淀粉200／0．5用于血液稀释对小儿血流动力学及凝血功能的影响

Influence of hydroxyethylstarch 200/0.5 on hemodynamic and coagulation in hemodflution for paediatrics patients

目的研究羟乙基淀粉（HES）200／0．5在急性高容量血液稀释（AHH）中对小儿血流动力学及凝血功能的影响。方法选取行围术前期AHH治疗的1～12岁ASAI～Ⅱ级患儿64例，将所有患儿按随机数字表法分为治疗组（HES200／0．5）和对照组（乳酸林格液）各32例。所有患儿人手术室后行麻醉诱导及麻醉维持，待麻醉平衡后对治疗组输注HES200／0．5，对照组输注乳酸林格液，两组均用乳酸林格液补充其余液体需要量。分别在行AHH前（L）、AHH结束后30min（T1）及AHH结束后60rain（T2）检测血流动力学指标和凝血功能指标。结果两组患儿AHH治疗前后平均动脉压（MAP）、HR、中心静脉压（CVP）、国际标准化比（INR）、活化部分凝血酶时间（Aerr）、凝血时间（CT）、血浆纤维蛋白原含量（FIB）组内差异无统计学意义，且组间差异也无统计学意义（均P〉0．05）。两组AHH治疗后红细胞计数（RBC）、红细胞比容（Hct）、血红蛋白（HB）Hct及Hb较治疗前均有所下降（均P〈0．05），组间差异无统计学意义（P〉0．05）。两组AHH治疗后心脏指数（CI）及凝血指标[凝血酶原时间（PT）]较治疗前均有所增加（均P〈0．05），组间差异无统计学意义（P〉0．05）。结论HES200／0．5在AHH治疗过程中不会对小儿血流动力学及凝血功能产生不良影响。

Objective To study the influence of hydroxyethylstarch 200/0.5 on hemodynamic and coagula- tion in hemodilution for paediatrics patients （AHH）. Methods 64 paediatrics patients who would receive AHH were selected. All patients were randomly divided into HES group（ received HES 200/0.5 ）and control group（ received so- dium lactate Ringerg） ,32 patients in each group. Hemodynamic efficacy and coagulation indexes were recorded before AHH（T0 ） ,30 min post-AHH （T1 ） and 60 rain post-AHH （T2 ）. Results There were no sinificant differences in MAP, HR, CVP, INR, AFIT, CT and FIB compared with To or between groups. RBC, Hct and Hb were significantly lower compared with TO, but no significant differences were observed between groups. CI and PT were significantly higher compared with To, but no significant differences were observed between groups. Conclusion There were no negative effects on hemodynamic efficacy and coagulation in paediatrics patients treating with HES 200/0.5.