肝移植术中运用贺斯和白蛋白对肺功能的影响  

Effect of Hydroxyethyl Starch and Albumin on Lung Function in Liver Transplantation

作　　者：徐海涛[1] 石学银[1] 袁红斌[1] 王亚华[1] 李永华[1] 朱秋峰[1] 

机构地区：[1]上海长征医院麻醉科,上海200003

出　　处：《临床军医杂志》2008年第2期190-192,共3页Clinical Journal of Medical Officers

基　　金：上海市卫生局科研基金资助(2006076)

摘　　要：目的探讨中分子羟乙基淀粉(贺斯)和白蛋白在肝移植术中应用对患者术后肺功能的影响。方法选择30例拟肝移植术患者,随机分为贺斯组和白蛋白组,分别与术后6、12、18 h取动脉血测定血气、混合静脉血气、计算氧合指数和肺泡-动脉氧分压差[P(A-a)DO2],记录术后呼吸机应用时间。结果白蛋白组术后12、24 h血管外肺水显著高于贺斯组(P<0.05);血管外肺水两组术后不同时间点P(A-a)O2的变化无明显差异;两组术后不同时间点氧合指数的变化无明显差异。白蛋白组患者术后呼吸机应用时间显著长于贺斯组(P<0.05)。结论贺斯能改善肝移植术后肺功能,与其治疗毛细血管渗漏综合征有关。Objective To observe the effect of 6% hydroxyethyl starch （HES） or 20% albumin for priming on lung function in hver transplantation. Methods Thirty patients undergoing liver transplantation were divided randomly into two groups： Group HES and Group Albumin. Respiratory index （RI） and P（A-a） DO2 were measured in the two groups at 6, 12 and 24 hours after operation and the use time of mechanical ventilator was recorded. Results Compared with that of Group HES, the extra-vascular lung water （EVLW） of Group Albumin was obviously increased in （ P 〈 0.05 ）. There was no significant difference between the two groups both in P（A-a） 02 and in RI at any of the time points. The use time of mechanical ventilator in Group Albumin was significandy higher than that in Group HES （ P 〈 0.05 ）. Conclusion HES can improve lung function after liver transplantation, which is related to capillary leak syndrome （CILS）.

关 键 词：羟乙基淀粉 白蛋白 肺功能 肝移植 

分 类 号：R617[医药卫生—外科学]