羟乙基淀粉(200/0.5)对血液流变学的影响

Effect of hydroxyethyl starch on blood rheology

目的 研究手术中输注 6 %羟乙基淀粉 (2 0 0 /0 5 )对机体血液流变学的影响。方法 4 0例外科手术患者随机分为 6 %羟乙基淀粉组 (2 0例 )及林格氏液组 (2 0例 ) ,术中分别输注 6 %羟乙基淀粉及林格氏液 10 0 0ml,采血测定全血粘度、血浆粘度、Hct、红细胞聚集指数、红细胞变形指数、纤维蛋白原等 ,以观察 6 %羟乙基淀粉溶液对机体血液流变学的影响。结果 6 %羟乙基淀粉组全血粘度、Hct、红细胞聚集指数、纤维蛋白原输注后较输注前明显降低 (P <0 0 5 ) ,红细胞变形指数明显升高与对照组比较相差显著 (P <0 0 5 )。 4 0例患者术中未用异体血。结论 6 %羟乙基淀粉可降低全血粘度 ,降低红细胞聚集性 ,明显改善机体血液流变学状态 ,有利于微循环灌注 。

Objective To investigate the effect of hydroxyl starch (HES 200/0 5) infusion on blood rheology during operation Methods Forty adult ASA Ⅰ Ⅱ patients (male 28, female 12) scheduled for elective operation on spine (26 patients) and lower extremities (14 patients) were enrolled in this study The age ranged from 18 56 yr and weight from 40 85kg Preoperative heart, lung, liver and kidney function tests, blood routine exam, bleeding and coagulation time were all normal No patients had any history of abnormal bleeding The patients were randomly divided into two equal groups: control group(C) receiving lactated Ringer solution 1 000ml during operation and HES group receiving 6% HES 1 000ml No patient received any plasma or whole blood during operation The patients were premedicated with intramuscular atropine 0 5mg and sodium luminal 0 1g The operations were all performed under continuous epidural block (1 6% lidocaine with adrenaline 1:200 000) BP,ECG,and SpO 2 were continuously monitored during operation Blood pressure was maintained with range and SpO 2 above 97% Venuos blood samples were taken before anesthesia , 30min and 4h after the fluid had been infused and 24h after operation for determination of blood viscosity, plasma viscosity, hematocrit(HCT) index of red blood cell (RBC) aggregation and deformation and index of fibrinogen Results Blood viscosity, Hct, index of RBC aggregation and fibrinogen decreased significantly (P<0 05) and index of RBC deformation increased significantly (P<0 05) in HES group They were significantly different from those in control group Conclusions 6% HES can significantly improve blood rheology and is beneficial to the microcirculatory perfusion