瓣膜置换术围体外循环期血浆胶体渗透压的控制  

A study of control colloid osmotic pressure in valve replacement surgery under extracorporeal circulation

作　　者：金孝梁[1] 陈志斌[1] 吕文艳[1] 赵鹏程[1] 张微微[1] 朱四海[2] 

机构地区：[1]解放军第117医院麻醉科,杭州市310013 [2]南京军区南京总医院麻醉科

出　　处：《临床麻醉学杂志》2008年第9期765-766,共2页Journal of Clinical Anesthesiology

摘　　要：目的比较以血浆和4%琥珀酰明胶作为预充液的患者围体外循环期血浆胶体渗透压(COP)的变化。方法 43例在体外循环下行瓣膜置换术患者,分为血浆预充组(A 组)和4%琥珀酰明胶预充组(B 组),检测患者麻醉后、体外循环后5 min COP,体外循环中维持 COP>16 mmHg。比较分析预充液 COP 与患者体外循环后 COP 的关系。结果体外循环后5 min,两组 COP 较麻醉后明显下降.与预充液 COP 呈正相关。B 组体外循环后5 min COP 明显高于 A 组。结论预充液COP 维持较高水平(>20 mm Hg)可以使患者体外循环期间 COP 达到有效水平。4%琥珀酰明胶预充维持 COP 较血浆更有优势。Objective To compare the changes of colloid osmotic pressure （COP） during extracorporeal circulation（ECC） using plasma or 4% succinylated gelatin for prime fluid. Methods Of 40 patients undervent heart valve replacement, 18 patients were given plasma （group A） and 25 patients 4% succinylated gelatin （group B） as prime fluid. The values of COP were measured after anesthesia induction, at 5 min during ECC, and 30 min after ECC. COP was kept greater than 16 mm Hg duing ECC. The changes of COP was compared between group A and B. Results COP was obviously lower at 5 min during ECC than after anesthesia induction, which was closely correlated with COP of the prime fluids. COP of patients was higher in group B than that in group A at 5 min during ECC. Conclusion COP of patients will reach an efficacious level when COP of prime fluid is kept above 20 mm Hg duing ECC. 4 % Succinylated gelatin is better than plasme as prime fluid duing ECC.

关 键 词：胶体渗透压 体外循环 4%琥珀酰明胶 

分 类 号：R654.2[医药卫生—外科学]