摘要
目的观察羟乙基淀粉(HES)溶液和琥珀酰明胶(GEL)溶液急性高容血液稀释(AHHD)对结肠癌患者围术期血小板膜糖蛋白Ⅱb／Ⅲa(GPⅡb／Ⅲa)、P-选择素表达的影响。方法择期在全身麻醉下行结肠癌根治术患者60例,ASAⅠ或Ⅱ级,随机分为3组(n=20):术前以15 ml·kg-1剂量分别在30min内经颈内静脉输注HES溶液(组Ⅰ)、GEL溶液(组Ⅱ)或乳酸钠林格氏(RL)溶液(组Ⅲ)。抽取静脉血标本,采用流式细胞仪测定AHHD前即刻(T0)、手术开始后30 min(T1)、手术开始后2 h(T2)和术毕1 h(T3)GPⅡb／Ⅲa与P-选择素的表达。结果与T0比较,组ⅠT1、T2和T3时GPⅡb／Ⅲa和P-选择素表达均降低;组Ⅱ,T1、T2时GPⅡb／Ⅲa和P-选择素表达降低,T3时GPⅡb／Ⅲa表达降低;组ⅢT1、T3时P-选择素表达增强(P<0．05)。与组Ⅱ比较,组ⅠT3时GPⅡb／Ⅲa表达降低;与组Ⅲ比较,组Ⅰ与组ⅡT1、T2和T3时GPⅡb／Ⅲa和P-选择素表达降低(P<0．05)。结论术前采用HES溶液或GEL溶液AHHD能抑制结肠癌根治术患者围术期血小板的过度活化,对防止肿瘤细胞转移和术后深静脉血栓形成可能有一定作用。
Objective To investigate the ettcct of acute hypervolemic hemodilution （AHHD） with hydroxy-ethyl starch （HES） or gelatin （GEL） on the expression of platelet glycoprotein Ⅱb/Ⅲa （GP Ⅱb/Ⅲ a） and P-selectin in patients with colon cancer during perioperative period.Methods Sixty ASA Ⅰ or Ⅱ patients of both sexes aged 35-73 yrs undergoing colon cancer surgery under general anesthesia were randomly divided into 3 groups （n=20 each） ： group Ⅰ HES; group Ⅱ GEL and group Ⅲ lactated Ringer＇s solution （RL）. HES （HAESstefil 6% Fresenius） or GEL （Gelofusin Braun） or RL 15 ml· kg^-1 was infused iv over 30 min immediately after induction of general anesthesia and before surgery. Blood samples were taken for determination of GP Ⅱb/Ⅲ a and P-selectin expression before AHHD （T0 , baseline） at 30 min （T1 ） and 2h （T2） after surgery was started amt 1h afterthe end of surgery （T3） by flow cytometry. Results The expression of GP Ⅱ b/Ⅲ a and P-selectin was significantly decreased after operation was started as compared to the baseline values at To in HES and GEL groups ; while P-selectin expression was significantly increased at T, and T3 as compared to the baseline at To, but there was no significant change in GP Ⅲ b/Ⅲ a after surgery was started in control group （group RL）, Conclusion AHHD with HES or GEL can inhibit over-activation of platelet during perioperative period of colon cancer surgery and may prevent metastases of cancer cells and postoperative deep vein thrombosis,
出处
《中华麻醉学杂志》
CAS
CSCD
北大核心
2006年第10期898-900,共3页
Chinese Journal of Anesthesiology
关键词
血液稀释
血小板膜糖蛋白类
结肠肿瘤
Hemodilution
Platelet membrane glycoproteins
Colonic neoplasms
