羟乙基淀粉130/0.4行高容血液稀释对手术全麻患者凝血功能的影响

目的探讨羟乙基淀粉130/0.4行高容血液稀释对手术全麻患者凝血功能的影响。方法 80例胃肠手术患者随机分为试验组和对照组,各40例。试验组输入20mL/kg羟乙基淀粉130/0.4进行快速扩容,术中以乳酸林格氏液补充其余体液需要量;对照组仅输入乳酸林格氏液。各组患者于急性高血容量血液稀释前、后1 h分别采血,检测Hct、PLT、PT、血小板最大凝集率、gbACT、CR、PF、TP、APTT。结果对照组治疗后Hct、PLT、PT、gbACT、血小板最大凝集率均较治疗前明显降低,PT、TP明显升高（P〈0.05）;试验组治疗后凝血功能各项指标均较治疗前明显改善（P〈0.05）。2组治疗后Hct、PT、CR、TP、PF、血小板最大凝集率有统计学差异（P〈0.05）。结论羟乙基淀粉130/0.4扩容效果明显,能有效维持循环稳定,是一种简单可行、安全有效的血液保护方法,值得临床推广应用。

Effect of hypervolemic hemodilution with hetastarch 130/0.4 on blood coagulation in patients under general anesthesia

Objective To explore the effect of hypervolemic hemodilution withhetastarch 130/0.4 on blood coagulation in patients under general anesthesia.Methods Eighty patients with gastrointestinal surgery were equally randomized into treatment group and control groups.In the treatment group,hetastarch 130/0.4（20 mL/kg） was infused for rapid expansion.Intraoperative lactate Ringer＇s solution was added to maintain fluid requirement.In the control group,only lactate Ringer＇s solution was infused.One hour before and after rapid hypervolemic hemodilution,blood samples were collected.Hct,PLT,PT,maximum platelet aggregation rate,gbACT,CR,PF,TP and APTT were examined.Results After treatment,Hct,PLT,PT,gbACT,maximum platelet aggregation rate in the control group was significantly lower.PT and TP significantly improved（P0.05）.After treatment,coagulation indicators in the treatment group significantly improved（P0.05）.After treatment,Hct,PT,CR,TP,PF,maximum platelet aggregation rate were significantly different between the two groups（P0.05）.Conclusion Hetastarch 130/0.4 has obvious expansion efficacy,can effectively maintain the circulatory stability. Using hetastarch is a simple,practical,safe and effective way for protecting blood,thus being worthy of popularization in clinical application.