以复方电解质为溶剂的羟乙基淀粉溶液研究进展

背景 羟乙基淀粉(hydroxyethylstarch,HES)是一种临床上广泛应用于容量替代和改善微循环的血浆代用品.以0.9%的NaCl溶液作为溶剂的HES,我们称之为非生理性的胶体,但过多的输入易导致高氯性酸中毒.近来,已研制出以复方电解质为溶剂的HES溶液,或可大大提高HES的安全性.目的 此文回顾了HES的基本理化性质及HES的研发历程,并讨论了新型的以复方电解质为溶剂的羟乙基淀粉溶液在维持酸碱平衡、凝血和肾功能等方面的优势.内容 越来越多的证据显示HES溶液与传统的HES相比,能够更好的维持酸碱平衡,对凝血功能的影响更小,在增加微循环灌注等方面也有独特的优势.此外,"生理性容量替代治疗"的初步研究结果也令人鼓舞.趋向 以复方电解质为溶剂的胶体在临床将会得到更为广泛的应用,"生理性容量替代治疗"的策略也为临床提供了良好的思路.

Advances of balanced hydroxyethyl starch

Background Hydroxyethylstarch (HES) is a widely used plasma substitute for correcting intravascular volume deficit and improving systemic hemodynamics as well as microcirculation. HES dissolved in isotonic saline may result in acid-base have been available. Purpose To review the chemical properties and the developing process of different generations of HES. The advantages of new balanced solutions over the unbalanced in acid -base status, coagulation and renal function are also discussed.Content Several studies demonstrated that such modern balanced HES preparations appeared to be safer with regard to acid-base balance, hemostasis, kidney function. Besides, the preliminary results in assessing the value of a total balanced volume replacement strategy including plasma-adapted HES solutions are quite promising. Trend The use of this new balanced HES will be widely Accepted in the future,and total balanced volume replacement strategy might be a pronising approach to further improves the safety of HES.