不同剂量羟乙基淀粉对结直肠癌手术患者血液流变学的影响

Effect of Different Doses of Hydroxyethyl Starch on Hemorheology in Patients during Colorectal Cancer Surgery

目的研究不同剂量羟乙基淀粉(130/0.4)用于结直肠癌手术患者对血液流变学的影响。方法结直肠癌手术患者60例,按照羟乙基淀粉补充剂量不同随机分为3组(每组20例):A组10 mL·kg-1、B组15mL·kg-1、C组20 mL·kg-1。观察并记录扩容前(T0)、扩容结束后30min(T1)、扩容后3.5h(T2)后的高(200s-1)、中(30s-1)、低(5s-1)切变率下全血粘度、血浆粘度(ηp)、红细胞刚性指数(ERI)、红细胞聚集指数(EAI)、红细胞压积(Hct)、全血高切还原粘度、全血低切还原粘度指标。结果与T0相比,A、B、C组患者全血低、中、高切变率下全血粘度、血浆粘度、红细胞压积及红细胞变形指数在T1、T2时均有明显下降(P<0.05);T2与T1比较,A组低切变率全血粘度、红细胞压积、红细胞聚集指数指标升高,差异有统计学意义(P<0.05);T0时,3组的低、中、高切变率全血粘度、血浆粘度、红细胞压积、全血高切还原粘度、全血低切还原粘度、红细胞刚性指数及聚集指数比较差异均无统计学意义;T1和T2时,C组与A组相比,患者全血粘度、红细胞刚性指数及聚集指数指标均降低(P<0.05);T2时,B组与A组相比,患者低、中、高切变率全血粘度、血浆粘度、红细胞压积、全血高切还原粘度、全血低切还原粘度、红细胞刚性指数及聚集指数差异无统计学意义。结论不同剂量羟乙基淀粉输入均能有效改善结直肠癌手术患者血液流变学状态,20mL·kg-1羟乙基淀粉的疗效较优。

Objective To explore the effect of different dose of hydroxyethyl starch( 130 /0. 4) on hemorheology in patients duringcolorectal cancer surgery. Methods 60 patients with colorectal cancer surgery were randomly divided into three groups according to various wan men supplement dose( 20 cases in each group) : 10 mL·kg-1( group A),15 mL·kg-1( group B),20 mL·kg-1( group C). Observe and record expansion( T0),expansion after 30 min before( T1),expansion after 3. 5 h( T2) of high( 200 s-1),medium( 30 s-1),low( 5 s-1) under the shear rate of whole blood viscosity,plasma viscosity( eta) p( ERI), erythrocyte rigidity index,erythrocyte aggregation index( EAI),red blood cells deposited( Hct) index. Results Compared with T0,patients' whole blood high,medium and low shear rate of whole blood viscosity, plasma viscosity,erythrocyte deposited and erythrocyte deformation index at T1,T2 in A,B,C groups significantly decreased( P < 0. 05). Compared with T1,low shear rate of whole blood viscosity,erythrocyte pressure volume,erythrocyte aggregation index at T2 in group A increased significantly( P < 0. 05). Compared group C with group A at T1,patients' whole blood viscosity,plasma viscosity,erythrocyte rigidity index and aggregation index showed significant difference( P < 0. 05). Compared group C with group A at T2,patients' whole blood viscosity,erythrocyte rigidity index and aggregation index showed significant difference( P < 0. 05). Conclusion Different doses of hydroxyethyl starch input can effectively improve the blood rheology in patients during colorectal cancer surgery and curative effect of 20 mL·kg-1hydroxyethyl starch is better.