6%羟乙基淀粉(130/0.4)对重度子痫前期患者围术期肾功能的影响

6% Hydroxyethyl Starch(130/0.4) on the Impact of Severe Preeclampsia Patients in Perioperative Renal Function

目的:观察使用羟乙基淀粉(130/0.4)对重度子痫前期患者围术期对肾功能的影响。方法:选取40例腰硬联合麻醉下行剖宫产术、重度子痫前期患者为研究对象,随机分为羟乙基淀粉组和乳酸林格氏液组,每组20例。比较两组患者术中液体输注总量及血压、心率和呼吸的变化。比较两组新生儿1 min和5 min Apgar评分。比较T0、T1、T2的Scr和β2-MG浓度,NAG、Uosm,以及24 h出血量和尿量。结果:羟乙基淀粉组的液体输注总量明显少于乳酸林格氏液组,差异有统计学意义(P<0.05)。两组新生儿1 min和5 min Apgar评分比较,差异无统计学意义(P>0.05)。羟乙基淀粉组手术前后患者血压、心率和呼吸的变化明显小于乳酸林格氏液组,差异均有统计学意义(P<0.05)。两组T0、T1和T2的Scr及β2-MG浓度、NAG比较,差异均无统计学意义(P>0.05)。两组24 h出血量和尿量比较,差异无统计学意义(P>0.05)。结论:羟乙基淀粉(130/0.4)和乳酸林格氏液均可用于重度子痫前期患者,羟乙基淀粉(130/0.4)在纠正低血容量、稳定血流动力方面更好;羟乙基淀粉(130/0.4)和乳酸林格氏液对重度子痫前期患者肾功能可能均无影响。

Objective：To observe the use of hydroxyethyl starch（130/0.4） in severe preeclampsia patients during the perioperative period of renal function.Method：40 patients with severe preeclampsia of lumbar epidural anesthesia for cesarean section were selected as the research object,and they were randomly divided into Hydroxyethyl Starch group and Lactated Ringer＇s Injection group,20 cases in each group.The total liquid intake,the change of blood pressure,heart rate and respiration of the two groups were compared during the operation;compared the Apgar scores at the 1 minute and 5 minutes.The concentration of Scr,β2-MG,NAG,Uosm and 24 hours amount of bleeding and urine volume of T0,T1,T2 were compared.Result：The liquid amount of hydroxyethyl starch group was significantly less than that of lactated Ringer＇s injection group,the difference was statistically significant（P〈0.05）.There were no significant differences（P〈0.05） of the Apgar score in 1 and 5 minutes between the two groups in.Before and after the operation,the maternal blood pressure,heart rate and respiration changes in the hydroxyethyl starch group were significantly less than those of lactated Ringer＇s injection group,the differences were statistically significant（P〈0.05）.Compared with Scr,β2-MG concentration,NAG at the time of T0,T1 and T2 between the two groups,there were no significant differences（P〈0.05）;compared with the 24 hours amount of bleeding and urine volume between the two groups,the differences had no statistic significant（P〈0.05）.Conclusion：Hydroxyethyl Starch（130/0.4） and Lactated Ringer＇s Injection can be used for severe preeclampsia,and Hydroxyethyl Starch（130/0.4） can be used in the correction of low blood volume,stable hemodynamics better;Hydroxyethyl Starch（130/0.4） and Lactated Ringer＇s Injection may have no effects on early renal function of preeclampsia patients.