术中输血与输羟乙基淀粉对人体安全性的研究

目的：观察和比较术中输异体血及输6％羟乙基淀粉（Hydroxyethyl Starch，HES）对机体内环境和凝血功能的影响。方法：将40例在全麻下择期胸腔手术患者随机分为输注异体血（A组）和输注6％羟乙基淀粉（B组），每组20例。在常规监测基础上，术中监测每例患者机体内环境，包括血常规、血气、电解质，监测术前、术毕及术后24h凝血酶原时间（PT）、部分凝血活酶时间（APTT）、纤维蛋白原浓度（FIB）和凝血酶时间（TT）。结果：A组血气改变及电解质紊乱较B组明显，2组患者PT、APTT术后较术前均明显延长（P〈0．05），FIB减少（P〈0．05），但仍在正常范围内，术后24 h2组患者的PT、APTT和FIB均恢复为术前水平，TT变化不明显。结论：输注6％羟乙基淀粉可减少输异体血的不良反应，维持机体水、电解质和酸碱平衡，对凝血功能无明显影响，可安全用于手术期的扩容治疗。

The Effects of Blood Transfusion and HES Infusion on Milieu Interieur and Coagulation

Objective: To observe and compare the effects of blood transfusion and hydroxyethyl starch (HES) infusion on milieu interieur and coagulation. Methods: Forty patients who underwent thoracic operation were randomly devided into two groups and each group was twenty cases:group A and group B.In group A patients received heterologous transfusion during operation,while in group B patients received 6% HES infusion.After anesthesia induction, milieu interieur was monitored including blood rutine,blood gases,electrolytes and 24 hours prothrombin time(PT),activated partial thromboplastin time(APTT),fibrinogen concentration(FIB), and thrombin time(TT) were measured before operation,at the end of surgery and 24 h after operation. Results: The changes of blood gases and electrolytes were significant in group A. While the conditions were stable relatively in group B.PT,APTT after operation were longer than those before operation(P < 0.05) and FIB was fewer(P < 0.05) but still within normal range.PT,APTT,FIB of 24 hours after operation of two groups all came back to preoperation level.There was no significant change in TT level. Conclusion: Six percent HES infusion can reduce the adverse reactions of heterologous transfusion and can maintain water, electrolyte level and acid-base balance.HES can be used for volume treatment during operation and there were not any disvantages for coagulation.