摘要
目的对比大剂量6%羟乙基淀粉130/0.4注射液和4%琥珀酰明胶注射液用于心脏直视手术围术期容量治疗的临床效果。方法40例择期行心脏瓣膜置换手术患者,美国麻醉医师学会病情和体格情况分级（ASA）Ⅱ-III级,年龄32~65岁,随机分为两组,从麻醉诱导后至术后第二天,分别采用4%琥珀酰明胶注射液（G组）和6%羟乙基淀粉130/0.4注射液（V组）进行体外循环预充、术中和术后血容量补充。观察患者临床恢复状况、围术期各时点血液动力学指标和血浆胶体渗透压的变化情况、各种液体的出入量、出血量和血制品使用情况。结果G组患者手术当天和术后第一天血浆代用品用量较多（P〈0.05）,两组间其余各项指标无显著性差异。结论大剂量6%羟乙基淀粉130/0.4注射液和4%琥珀酰明胶均可安全用于心脏直视手术围术期容量治疗,6%羟乙基淀粉130/0.4注射液扩容时效较持久。
OBJECTIVE To compare the clinical effect of using flushing does 4% succinylated gelatin and 6% hydroxyethyl starch 130/0.4 for perioperative plasma volume substitution therapy in heart surgery.METHODS 40 ASA Ⅱ-Ⅲ patients（from 32 to 65 years） scheduled for valves replacement surgery were divided into 2 equal groups,randomly accepted hydroxyethyl starch（group V）and succinylated gelatin（group G） as the artificial colloid for acute hemodilution,priming of the heart-lung machine,and for intra-and postoperative plasma volume substitution from induction of anesthesia until post operation day 2.Efficacy was evaluated by comparing the hemodynamic parameters,amount of colloid infused,colloid osmotic pressure（COP）,blood loss and allogeneic blood products using condition of two groups.RESULTS There were no significant differences in hemodynamic parameters,blood loss and COP between two groups.The amount of colloid infused after operation using in group G was much more（P〈0.05）. CONCLUSION Both 4% succinylated gelatin and 6% hydroxyethyl starch 130/0.4 are effective perioperative plasma volume expander in heart surgery.We found less amount of 6% hydroxyethyl starch 130/0.4 infused to achieve similar hemodynamic parameters and COP.
出处
《中国体外循环杂志》
2007年第3期142-145,共4页
Chinese Journal of Extracorporeal Circulation
基金
教育部门博士点基金支持(20060023045)
关键词
心脏手术
血浆代用品
羟乙基淀粉
明胶
体外循环
Cardiac surgery
Volume replacement
Hydroxyethyl starch
Gelatin
Extracorporeal circulation
