三种胶体液行急性高容血液稀释对患者血流动力学及内环境的影响  

The effects of three colloids of acute hypervolemic hemodilution on hemodynamics and internal environment

作　　者：牛宣耀[1] 张雁[1] 

机构地区：[1]附属菏泽市立医院,山东菏泽274031

出　　处：《菏泽医学专科学校学报》2011年第1期13-16,共4页Journal of Heze Medical College

摘　　要：目的比较高渗氯化钠羟乙基淀粉40、130/0.4羟乙基淀粉和聚明胶肽行AHH对患者血流动力学及内环境的影响。方法择期胃肠道肿瘤患者80例,ASAI或Ⅱ,随机等分为四组。全麻插管后从中心静脉输注A组(高渗氯化钠羟乙基淀粉40)(4 ml/kg、10 ml/min),B(130/0.4羟乙基淀粉)、C(聚明胶肽)和D组(乳酸钠林格液)(15 ml/kg3、0 ml/min)。即时监测血压、心率变化,记录T0(AHH前即时)、T1(AHH后即时)、T2(AHH后30 min)、T3(AHH后1 h)、T4(术毕)时HR、CVP、Na+、Lac、Hct、Hb及术中输液量、失血量、尿量、输血例数等。结果 CVP:A、B、C组T1-3及D组T1、T2时较T0明显升高,A、B、C组T1-3较D组同时点明显升高;Na+:A组T1-3较T0及B、C、D组同时点明显升高;Hct和Hb:四组患者T1-4较T0均明显降低,A、B、C组T1-3较D组同时点明显降低;D组羟乙基淀粉输入量、失血量及输血例数明显多于其余三组。结论三种胶体液均为理想的血浆代用品,但需高度关注高渗氯化钠羟乙基淀粉40术中Na+的升高。Objective To compare the effects of three colloids of AHH on hemodynamics and internal environment.Methods 80 patients were randomly divided into four groups： Group A（hypertonic saline hydroxyethyl starch 40）,Group B（hydroxyethyl starch 130/0.4）,group C（polygeline） and group D（lactated ringer＇s solution）.After general anesthesia,liquids were infused by the central venous access.Group A（4ml/kg,10ml/min）,Group B,C,D（15ml/kg,30ml/min）.CVP,Na＋,Lac,Hct,Hb were recorded at T0（AHH before the real-time）,T1（AHH immediately）,T2（AHH after 30min）,T3（AHH after 1h）,T4（end of surgery）.Blood pressure,HR,the amount of liquids transfusion,urine,blood loss and blood transfusion were recorded.Results In patients of colloids infusion,CVP increased,Hct,Hb,the cases of blood transfusion reduced,Na＋ increased during surgery but less than the normal upper limit in group A.Lac were no significantly difference in all the patients.Conclusion Three colloids can maintain hemodynamic stability,reduce bleeding and allogeneic blood transfusion,have less side effects to internal environmental in patients,so they were ideal plasma sustitutes.

关 键 词：胶体液 血液稀释 血流动力学 内环境 

分 类 号：R973.5[医药卫生—药品] R971.2[医药卫生—药学]