体外循环中贺斯和佳乐施对凝血功能的影响  

The Effect of Hydroxyethy Starch and Gelatin on Coagulation in the Operation with Cardiopulmonary Bypass

作　　者：钱金兰[1] 李欣[1] 郭震 刁文瑜[1] 徐凌峰[1] 吴金宝[1] 殷凤珍[1] 丁慧萍[2] 

机构地区：[1]上海市胸科医院体外循环室,上海200030 [2]上海市胸科医院麻醉科,上海200030

出　　处：《中国体外循环杂志》2004年第4期204-206,共3页Chinese Journal of Extracorporeal Circulation

摘　　要：目的　探讨 6 %中分子羟乙基淀粉和 4 %的琥珀明胶用于体外循环预充时 ,对患者凝血功能的影响。方法　选择 38例瓣膜替换术的患者 ,随机分为贺斯组和佳乐施组。分别在麻醉前及鱼精蛋白中和后 30min取静脉血1ml,运用Sonoclot凝血及血小板功能分析仪测定凝血功能 ,测定参数有 :激活凝血时间 (SonACT)、凝血速率 (ClotRate)、血小板功能 (PlateletFunction) ,并描绘凝血过程曲线图。结果　两组间激活凝血时间、血小板功能术前术后均无显著性差异 ,但术后凝血速率贺斯组明显小于佳乐施组。结论　佳乐施与贺斯 1 0 0 0ml用于预充时对凝血功能无显著影响 ,但与佳乐施相比 ,贺斯对凝血通路中纤维蛋白形成速率抑制相对较强。OBJECTIVE To observe the effect of 6% hydroxyethel starch(HES) and 4% succinylated gelatin(GEL) for priming on coagulation in the operation with cardiopulmonary bypass(CPB). METHODS Thirty-eight patients ondergoing valve replacement were divided randomly into two groups: Group HES and Group GEL. The SonACT, Clot Rate and Platelet Function were measured in the two groups before anaesthesia and 30 minutes after protamine was neutralized using the Sonoclot Analyzer. RESULTS There is no significant difference between these two groups before and after CPB in terms of coagulation data: SonACT and Platelet Function ( P>0.05), but the clot rate in the GEL group decreased significantly after CPB ( P<0.05 ). CONCLUSION There is no significant effect on coagulation when 1000ml HES and GEL were used for priming, but the effect of restraining the fibrin formation is stronger in HES.

关 键 词：贺斯 佳乐施 凝血功能 血小板功能 体外循环 凝血时间 预充 患者 术后 影响 

分 类 号：R654.1[医药卫生—外科学]