羟乙基淀粉溶液对腹腔镜胆囊切除患者血液流变学特性的影响  

Influence of hydroxyethyl starch solution on hemorrheology in patients of laparoscopic cholecystectomy

作　　者：欧希[1] 刘晓平[1] 刘吉奎[1] 熊沛[1] 

机构地区：[1]北京大学深圳医院肝胆外科,广东深圳518036

出　　处：《岭南现代临床外科》2012年第2期87-91,共5页Lingnan Modern Clinics in Surgery

基　　金：深圳市科技计划项目(医疗卫生类)(项目编号:201103023)

摘　　要：目的观察腹腔镜气腹及术中使用羟乙基淀粉130/0.4溶液对腹腔镜胆囊切除患者血液流变学特性的影响。方法 60名腹腔镜胆囊切除术患者于术前、建立气腹后、使用HES130/0.4溶液(对照组使用林格氏液)后、术后四个时间点检测全血粘度(WBV)、血浆粘度(PV)、红细胞压积(HCT)、血沉(ESR)、血沉方程K值(ESRK)、红细胞刚性指数(RI)、红细胞聚集指数(EAI)。结果建立气腹后患者WBV、PV、RI、EAI均较术前明显升高;使用HES130/0.4溶液后,患者WBV、HCT、EAI、ESRK明显下降,治疗组较对照组下降幅度大;术后非老年患者指标恢复正常,但老年患者WBV、PV、HCT、EAI仍有升高。结论腔镜手术中气腹影响患者特别是老年患者血液流变学特性,而术中使用HES130/0.4溶液可以有效降低血液粘度、改善微循环。Objectives To investigate the effects of hydroxyethyl starch （HES） l30/0.4 solution in the course of pneumoperitoneum and infusion on hemorheological parameters of patients undergoing laparoscopic cholecystectomy （LC）. Methods The blood samples from sixty patients underwent LC were taken for determination of hemorheology variables before and after pneumoperitoneum establishment in present and absent of HES 130/0.4 solution. The hemorheological parameters were measured including WBV, PV, HCT, ESR, ESR K, RI and EAI. Results WBV, PV, RI and EAI were increased significantly after pneumoperitoneum, The values of WBV, HCT, EAI and ESR K were significantly decreased in the administration of HES 130/0.4 solution,as compared with controls. The younger patients recovered on the first morning after operation, however WBV, PV, HCT and EAI of elderly patients were still higher. Conclusions The pneumoperitoneum can affect the hemorheological characters of patients（especially the elderly patients） in LC. Loading HES can hold the blood viscosity in a lower level, ameliorate the microcirculation and decrease.

关 键 词：羟乙基淀粉溶液 气腹 腹腔镜胆囊切除术 血液流变学 

分 类 号：R446.112[医药卫生—诊断学]