高渗氯化钠羟乙基淀粉对成人心内直视手术患者凝血功能及心功能的影响  

Impact of hypertonic sodium chloride hydroxyethyl starch on coagulation and cardiac function in patients with adult open heart operation

作　　者：祝劲松[1] 王凌浩[1] 韩徐[1] 唐松江[1] 

机构地区：[1]贵阳中医学院第一附属医院麻醉科,贵阳市550001

出　　处：《临床合理用药杂志》2014年第1期22-23,共2页Chinese Journal of Clinical Rational Drug Use

摘　　要：目的观察高渗氯化钠羟乙基淀粉40注射液(HSS40)对成人心内直视手术患者凝血功能及心脏功能的影响。方法将30例行体外循环(CPB)心内直视术患者,据人工心肺机预充液配方分为Ⅰ组和Ⅱ组各15例。Ⅰ组:为6%羟乙基淀粉130/0.4(万汶)750ml和乳酸林格氏液750ml;Ⅱ组:HSS40 750ml(霍姆)和乳酸林格氏液750ml。观察2组术前术后凝血功能指标、凝血酶原时间(PT)、活化部分凝血酶原时间(APTT)、血浆纤维蛋白原(Fib)及心脏复跳情况。结果术后2组PT、APTT水平均高于术前,Fib水平低于术前,差异均有统计学意义(P<0.05)。Ⅱ组心脏复跳率高于Ⅰ组,差异有统计学意义(P<0.05)。结论适量预充HSS40对心脏手术成人患者的凝血功能无明显影响,同时可提高心脏复跳成功率,但安全性和可行性需进一步探讨。Objective To observe the impact of hypertonic sodium chloride hydroxyethyl starch 40 injection （HSS40） on coagula- tion and cardiac function in patients with adult open heart operation. Methods 30 cases patients with adult open heart operation under car-diopulmonary bypass （CPB） were divided into I group and 11 group, each of 15 cases, according to the artificial heart-lung machine prefilled recipes. Ⅰ group were given 6% hydroxyethyl starch 130/0.4 （voluven） 750ml and ringer＇s lactate 750ml; lI group were given HSS40 750ml （holm） and ringer＇s lactate 750ml. Observed coagulation parameters, prothrombin time （PT）, activated partial thromboplastin time （APTT） ,fibrinogen （Fib） and cardiac resuscitation situations of two groups preoperative and postoperative. Results Postoperative, PT and APTT levels of 2 groups were higher than preoperative ,Fib levels were lower than preoperative ,the differences were statistically significant （P 〈 0.05 ）. Cardiac resuscitation rate of Ⅱ group was higher than that of I group, the difference was statistically significant （P 〈 0.05 ）. Conclusion Appropriate amount pre-charge of HSS40 has no significant effect on coagulation function in patients with adult open heart op-eration, while improving the success rate of cardiac resuscitation, but the safety and feasibility should be further explored.

关 键 词：高渗氯化钠 羟乙基淀粉 心内直视手术 凝血功能 肾功能 

分 类 号：R614[医药卫生—麻醉学]