羟乙基淀粉对血液流变学的影响

Effect of hydroxyethyl starch on hemorrheology

目的 :观察羟乙基淀粉 ( HES)对手术病人血液流变学的影响。方法 :将 40例外科手术病例随机分为实验组 ( HES)和对照组 (乳酸林格液 )各 2 0例。全部病人采用硬膜外麻醉 ,术中分别输注 HES和乳酸林格液各 1 0 0 0 ml。采血对全血粘度、血浆粘度值、血沉、红细胞压积、全血还原粘度、血沉方程 K值、全血相对粘度、红细胞变形指数 TK等进行检测 ,以观察 HES对手术病人血液流变学的影响。结果 :HES组不同切变的全血粘度、红细胞压积、全血高切还原粘度及红细胞变形指数 TK输注后明显降低 ( P<0 .0 1 ) ,血浆粘度、全血低切还原粘度、全血高切相对粘度也有降低 ( P<0 .0 5 )。结论

Objective:To investigate the hydroxyethyl starch (HES 200/0.5) infusion on hemorheological indexes in surgery patients by epidural anesthesia.Methods:Forty patiens with ASAⅠ～Ⅱwere divided randomly into HES group (20 patients) and control group (20 patients). All patients were used in epidural anesthesia. The patients in HES group were infused by hydroxylethyl starch 1000ml and the patient in control group were infused by lactaled Ringer solution 1000ml. No patient received any plasma or whole blood during operation. Venuos blood samples were taken before anesthesia,2h after the fluid had been infused and 12h after operation for determination of whole blood viscosity (high, middle, low shear rates), plasma viscosity, erythrocyte sedimentation rate (ESR), hematocrit (Hct), whole blood reduced visosity, K titer in the ESR equation, whole blood relative viscosity and RBC doformability indexes TK.Results: Whole blood viscosity (high, middle, low shear rates), hematocrit , whole blood reduced viscosity,decreased significantly (P<0.01) and plasma viscosity, whole blood reduced viscosity (low shear rates), whole blood ralative viscosity (high shear rates) decreased also (P<0.05)after infusion in HES group. Conclusion:6% HES can significantly improve hemorrheology for surgery patient.