羟乙基淀粉对全麻下行结直肠癌手术患者凝血功能的影响  

The Effects of Hydroxyethyl Starch on Coagulation Function in Patients Performed Colorectal Cancer Surgeries

作　　者：刘斐[1] 孟尽海[2] 吴燕[1] 王春生[1] 姚杰[1] 

机构地区：[1]宁夏医科大学研究生学院,银川750004 [2]宁夏医科大学总医院,银川750004

出　　处：《宁夏医科大学学报》2013年第11期1219-1222,共4页Journal of Ningxia Medical University

基　　金：宁夏卫生厅重点科研课题(2011003)

摘　　要：目的研究静脉输注不同剂量羟乙基淀粉(130/0.4)对结直肠癌手术患者凝血功能的影响。方法结直肠癌手术患者60例,按照静脉输注不同剂量羟乙基淀粉随机分为A、B、C三组,每组20例,分别静脉输注羟乙基淀粉10、15和20mL·kg-1。观察并记录扩容前(T0)、扩容结束后30min(T1)、扩容后3.5h(T2)的凝血酶原时间(PT)、活化部分凝血酶原时间(APTT)、纤维蛋白原(FIB)、血红蛋白、血小板计数(PLT)等指标。结果组内比较:与T0相比,三组PT值在T1时均有不同程度延长(P<0.05),C组在T2时PT值仍高于T0时(P<0.05);A、B组中APTT值在T1、T2时与T0时比较明显延长(P<0.05),C组在T1、T2时与T0比较差异无统计学意义;三组FIB值在T1、T2时均有不同程度减少(P<0.05);三组血红蛋白浓度在T1时均降低(P<0.05),C组在T2时血红蛋白浓度仍高于T0时(P<0.05);三组血小板计数在T1时均降低(P<0.05);A、B组在T2时较T0时明显降低(P<0.05);C组在T2时与T0比较差异无统计学意义。不同指标T1与T2比较及各组组间比较差异均无统计学意义。结论对于结直肠癌手术患者,术中输入羟乙基淀粉会较小程度改变凝血功能参数,但均在正常范围之内,不同剂量的羟乙基淀粉对凝血功能无明显影响。Objective To investigate the effects of hydroxyethyl starch( 130 /0. 4) on coagulation function in patients performed colorectal cancer surgeries. Methods 60 aged patients were involved and randomly assigned to 3 groups according to different doses of hydroxyethyl starch they received: group A( 10 mL·kg- 1),group B( 15 mL·kg- 1),group C( 20 mL·kg- 1). Prothrombin time( PT),activated partial prothrombin time( APTT),fibrinogen( FIB),hemoglobin,platelet count( PLT) were monitored and recorded before the capacity,after the capacity 30 min( T1),3. 5 h( T2). Results Compared with T0,PT of the three groups were longer when the T1( P < 0. 05). Group C in the T2 values of PT was still higher than that when the T0( P <0. 05). Group A and B values of APTT in T1,T2 with obvious extended when T0( P <0. 05). Group C in comparison with T0,T1,T2 difference had no statistical significance. Three groups of FIB values in T1,T2had varying degrees of reduced( P < 0. 05). Three groups of hemoglobin concentrations were lower at the time of T1 group C( P < 0. 05) while hemoglobin concentration in T2 was still higher than that when T0( P <0. 05). Three groups of platelet count were lower at the time of T1( P < 0. 05). Conclusion For patients with colorectal cancer surgeries,less hydroxyethyl starch will change coagulation function parameters,but all within normal range. No different effect was found in different doses of hydroxyethyl starch.

关 键 词：羟乙基淀粉 凝血功能 麻醉 

分 类 号：R735.37[医药卫生—肿瘤]