心脏直视手术应用不同血浆代用品对机体的影响  

Effects of different plasma substitutes on patients during cardiac surgery

作　　者：刘岸新[1] 刘晓明[1] 李蔚然[1] 刘凤珍[1] 

机构地区：[1]首都医科大学附属北京安贞医院体外循环科,100029

出　　处：《中国医药》2013年第1期22-24,共3页China Medicine

摘　　要：目的比较新一代中分子羟乙基淀粉与琥珀酰明胶用于体外循环心脏手术时对机体的影响，探讨二药在心血管手术中容量治疗的有效性和安全性。方法选择54例行瓣膜置换术的患者，完全随机分为羟乙基淀粉组和琥珀酰明胶组，各27例。羟乙基淀粉组在体外循环前、体外循环中及术后住ICU期间应用羟乙基淀粉作为体外循环预充液和补充血容量的血浆代用品；琥珀酰明胶组同期应用琥珀酰明胶作为体外循环预充液和补充血容量的血浆代用品。观察并比较2组患者围术期生命体征、血浆胶体渗透压、液体出入量。结果2组患者均痊愈出院。2组患者各时间血压差异均无统计学意义（P〉0．05）。羟乙基淀粉组诱导后、术毕、ICU2h、ICU6h和ICU20h的胶体渗透压分别为（19．2±2．0）、（19．3±4．6）、（17．0±2．1）、（20．7±2．2）、（20．5±2．2）ITIITIHg，琥珀酰明胶组分别为（18．1±2．3）、（16．9±2．0）、（16．9±2．3）、（19．3±4．5）、（20．0±2．1）mmHg，2组差异无统计学意义。结论羟乙基淀粉与琥珀酰明胶可安全用于心脏直视手术围术期的容量治疗。Objective To compare the clinical effects of a new generation of 6% hydroxyethyl starch 130/ 0.4 and 4% succinylated gelatin on patients in cardiac surgery with cardiopulmonary＂ bypass （CPB） , and to further explore the effectiveness and security of both plasma substitutes during cardiovascular surgery. Methods Fifty-four patients of valve replacement surgery were randomly divided into two groups. In one group （ n = 27 ） , the 6% hydroxyethyl starch 130/0.4 was applied as the primary plasma substitutes to supply the blood volume during the cardiovascular surgery. The patients of the other group （ n = 27） , as the control, were applied the 4% sueeinylated gelatin as the priming solution and plasma substitutes in perioperative period. The normal vital signs of patients were analyzed in perioperative period. Plasma marker of patients, fluid intake and output were also detected in perioperative period. Results All patients were recovered. There were no significant differences in the normal vital signs of patients between two groups （P 〉 0.05 ）. Plasma colloid osmotic pressure of patients and fluid intake and output were also no significantly different between two groups. Conclusions There are no differences in 6% hydroxyethyl starch 130/0.4 and 4% succinylated gelatin during cardiac surgery. Both plasma substitutes can be used in heart surgery safely and effectively.

关 键 词：心脏手术 体外循环 羟乙基淀粉 琥珀酰明胶 

分 类 号：R659.2[医药卫生—外科学]