万汶／乳酸林格氏液对子宫肌瘤患者血液动力学和酸碱平衡的影响

目的比较子宫肌瘤患者输注万汶（130／0．4，6％羟乙基淀粉）／乳酸林格氏液时对血液动力学和动脉血酸碱平衡的影响。方法50例择期子宫肌瘤手术患者，ASAⅠ—Ⅱ级，随机分为万汶组（V组，n=25）和乳酸林格氏液组（L组，n=25），分别经静脉20min内快速输注万汶或乳酸林格氏液10ml／kg，随后两组均按2ml／kg·h的速度输注乳酸林格氏液。记录静脉输注开始时及开始后20、40、60min各时间点SBp、DBp、HR、CVP及部分动脉血气分析结果（pH、BE、Hb、Lac^-1、Cl^-1）。结果与基础值相比，CVP在输注开始后两组均显著上升（P〈0．05），且V组CVP升高显著（P〈0．05）；在观察各时间点上SBp、DBp和HR两组均无显著差异。pH、BE和Hb在输注开始后即轻度下降（P〈0．05），但L组的pH在扩容后60min、Hb在扩容后40min基本恢复至基础值；V组Cl^-1和I，组Lac^-1在扩容后显著上升（P〈0．05），但V组Cr在扩容后60min基本恢复至基础值。结论快速输注万汶或乳酸林格氏液均可有效扩容，两者相比万汶扩容效果更好更持久。

Effect of voluven/lactate Ringer''''s solution infusion on hemodynamics and acid-base balance in patients with hysteromyoma

Objective To investigate the effect of voluven(130/0.4,6% hydroethyl starch) /lactate Ringer's solution on hemodynamics and acid-base balance in patients with hysteromyoma.Methods Fifty female patients with hysteromyoma,ASA I-II,were randomly divided into voluven group(group V,n=25) and lactate Ringer's solution group(group L,n=25).They were intravenously quickly infused with voluven or lactate ringer's solution 10 ml/kg within 20 min,and then with lactate ringer's solution 2 ml/kg/h.SBP,DBP,HR,CVP and some results of arterial bloodgas analysis measured(PH,BE,Hb,Lac-,Cl-).Results Compared with the baseline,CVP significantly increased after infusion of fluid in both group(P<0.05),moreover CVP in V group was higher than that in L group(P<0.05).SBP,DBP and HR had no significant changes at every time points in both groups.PH,BE and Hb slightly but significantly decreased after infusion of fluid in both groups(P<0.05),however PH of 60 min and Hb of 40 min,respectively,after infusion of fluid in group L returned to the baseline.Cl-in group V and Lac-in group L significantly increased after infusion of fluid(P<0.05),however Cl-of 60 min after infusion of fluid in group V returned to the baseline.Conclusions Intravenous quick infusion of voluven or lactate Ringer's solution presents the effect of fluid expansion.The effect of fluid expansion of voluven is better and longer than that of lactate Ringer's solution.