羟乙基淀粉测定血容量及指导手术抗休克40例

Determination of Rapid Blood Volume with Hydroxyethyl Starch and Its Directive Effect on Intraoperative Antishock Therapy

目的 :探讨羟乙基淀粉用于测量血容量 (BV)的可行性及对术中抗休克治疗的指导作用。方法 :选择休克指数 >1的手术患者 2 0例作为A组 ,腹部外科择期手术患者 2 0例为B组。术前静脉快速滴注 6%羟乙基淀粉 10 0ml,5min后取动脉血测定血浆中葡萄糖浓度为G1值。然后血浆与盐酸混合 ,10 0℃水浴 7min后测定血浆中葡萄糖浓度为G2值。根据公式 :BV(ml) =3 0 82×HET(ml) /(G2 -G1) /( 1-Hct)计算血容量。记录术前和术毕的休克指数、血容量和心率等指标。结果 :术前A组的休克指数和心率明显高于B组 ;血容量显著低于B组。术毕两组上述指标差异不显著。结论 :用羟乙基淀粉作为标记物可快速准确地测定血容量 ,用于指导休克患者术中的液体治疗 。

Objective:To investigate the possibility of using hydroxyethyl starch to determine rapidly blood volume (BV) and its directive effect on intraoperative antishock therapy. Method:Twenty shock (shock index is more than 1) patients with acute abdomen were selected as group A, and twenty patients chosed for abdominal operation were acted as group B. Before operation, each patient receiving 6% hydroxylethyl starch 100 ml was rapidly injected intravenously. An arterial blood sample was drawn 5 min after injection and plasma glucose concentration was measured and recorded as G 1. The hydrochloride acid was added to the plasma, and the mixture was boilded for 7 min. the plasma glucose concentration were detected and recorded as G 2. The BV was calculated on the basis of: BV(ml)=3 082×HET(ml)/(G 2-G 1)/(1-Hct). Shock index, blood volume and heart rate were measured before operation and at the end of operation. Results:Shock index and heart rate of patients in group A were significantly higher than those in group B before operation. Blood volume of patients in group A was significantly lower than group B. At the end of operation, the variables measured above had no significant difference between two groups. Conclusion:Blood volume can be determined rapidly and accurately with hydroxyethyl starch as a marker. The antishock effect is significantly available when the technique is used in the intraoperative fluid therapy.