缩合葡萄糖氯化钠高容量血液稀释对血流动力学的影响  

Effects of Hypervolemic Hemodilution with Polyglucose Sodium Chloride on Hemodynamics

作　　者：夏磊铭[1] 姚尚龙[1] 袁世荧[1] 

机构地区：[1]华中科技大学同济医学院附属协和医院麻醉学教研室,武汉430022

出　　处：《医学新知》2005年第2期33-35,39,共4页New Medicine

摘　　要：目的采用缩合葡萄糖氯化钠进行高容量血液稀释,观察患者血流动力学的改变。方法30例拟行肺叶部分切除术的病人,随机分为A、B、C3组,于麻醉平稳后分别输注缩合葡萄糖氯化钠注射液、10%中分子羟乙基淀粉溶液和乳酸林格氏液15ml/kg,输液时间均为30min。于输液前、输液后30min监测血流动力学指标。结果①A组输液后心输出量、降主动脉血流量、每搏量和降主动脉每搏量与输液前相比均显著增加(P<0.05);②A、B两组输液后体循环阻力与输液前相比显著下降(P<0.05);③B组输液后加速度、峰值流速与输液前相比显著增加(P<0.05);④3组病人输液后平均动脉压、心率和左心室射血时间指数与输液前相比均无显著差异(P>0.05)。结论输注缩合葡萄糖氯化钠注射液显著升高心输出量,降低外周血管阻力。提示缩合葡萄糖氯化钠注射液进行急性高容血液稀释对心肌功能无抑制作用。Objective To investigate the effects of polyglucose sodium chloride on hemodynamics.Methods 30 patients receiving pulmonary lobectomy were randomly divided into three groups (A,B and C). Polyglucose sodium chloride, 10% hydroxyethyl starch (HES) and Ringer's solution (15 ml/kg) were infused for these groups respectively. Hemodynamic parameters were monitered for these patients before and after the liquid infusion.Results Cardiac output (CO) was significantly increased after polyglucose sodium chloride was infused. Descending aorta flow (ABF), stroke volume (SV), and stroke volume in the descending aorta (SVa) were significantly increased after polyglucose sodium chloride was infused , but these parameters did not change in group B and group C. Total systemic vascular resistance (TSVRa and TSVR) significantly decreased than baseline after polyglucose sodium chloride or 10% hydroxyethyl starch (HES) was infused . Mean artery pressure (MAP), heart rate (HR), left ventricular ejection time index (LVETi) did not change among three groups. In addition, acceleration (Acc) and peak velocity (PV) were significantly increased when 10% hydroxyethyl starch (HES) was infused. Conclusion Cardiac output increased significantly, systemic vascular resistance decreased significantly, and heart rate (HR), LVETi don't change after polyglucose sodium chloride infusion, which indicates that acute hypervolemic hemodilution with polyglucose sodium does not depress myocardial function.

关 键 词：高容量血液稀释 缩合葡萄糖氯化钠注射液 急性高容血液稀释 肺叶部分切除术 羟乙基淀粉溶液 血流动力学指标 乳酸林格氏液 外周血管阻力 心输出量 输液前 输液后 动脉血流量 平均动脉压 输液时间 降主动脉 循环阻力 峰值流速 

分 类 号：R614[医药卫生—麻醉学] R977.8[医药卫生—外科学]