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Objective To investigate the effects of acute hypervolemic hemodilution (AHH) with different fluids on blood rheology in patients with deep vein (femoral and iliac) thrombosis. Methods Thirty ASA I or II patients aged 40-64 yr who had developed deep vein thrombosis in 48 h and were scheduled for embolectomy were randomly divided into 3 groups ( n = 10 each) ; group I normal saline (NS) ; group II 6 % HES 200/0.5 ( HES) ; group IE gelofusine (GEL). AHH was performed with normal saline, 6% HES or gelofusine infusion at 20 ml·kg-1 ·h-1 for 40 min. MAP, HR and SpO2 were monitored. Blood loss, volume of blood transfusion and fluid infused and urine output during operation were recorded. Anesthesia was induced with fentanyl 3-5 fig/kg, etomidate 0.15-0.30 mg/kg, propofol 1-2 mg/kg and succinylcholine 1-2 mg/kg and maintained with 2% isoflurane and propofol infusion at 5-8 mg·kg-1·h-1 and intermittent iv boluses of vecuronium. The patients were mechanically ventilated (VT 8 ml/kg, RR 12 bpm). PaO2 and PaCO2 were maintained within normal range. Venous blood samples were obtained before and after AHH for measurement of hematocrit (Hct), whole blood viscocity (WBV) at low or high shear rates, plasma viscosity, RBC aggregation and RBC deformation. RBC aggregation index and RBC deformation index were calculated. Results MAP and HR were stable in all patients. The amount of blood transfusion and fluid infused was significantly less in group HES and GEL than in group NS. The WBV at low or high shear rates in group HES and GEL, Hct in all 3 groups and RBC aggregation index in group HES were significantly decreased after AHH, but the RBC deformation index was significantly increased in group HES. Conclusion Colloid is better than crystalloid and HES is better than gelofusine in improving intraoperative hypercoagulability and sluggish blood flow. 相似文献
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急性胰腺炎的诊治进展 总被引:1,自引:0,他引:1
李斌 《中华现代外科学杂志》2005,2(13):1195-1199
急性胰腺炎(acute pancreatifis,AP)是指多种病因引起的胰酶激活,继以胰腺局部炎症反应为主要特征,伴或不伴有其他器官功能改变的疾病。临床上,大多数患者的病程呈自限性;20%~30%患者临床经过凶险。总体死亡率为5%~10%。AP临床上表现为急性、持续性腹痛(偶无腹痛),血清淀粉酶活性增高大于或等于正常值上限3倍,影像学提示胰腺有(无)形态改变,排除其他疾病者。可有(无)其他器官功能障碍。少数病例血清淀粉酶活性正常或轻度增高。 相似文献
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口服吸附剂是治疗慢性肾功能衰竭的有效手段之一,对于延迟肾衰发展进程,减少尿毒症的发生和血液透析的次数,尤其对于慢性肾功能衰竭早期预防和治疗是非常重要的。口服吸附剂疗法由于安全有效,价格低廉,便于服用,近年来备受关注,已逐渐成为治疗慢性肾衰竭的重要手段。目前,“吸附疗法”己被列为尿毒症的现代治疗方法之一。 相似文献
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介绍了一种从谷朊粉废水中提取戊聚糖的工艺,由此工艺得到的产品(戊聚糖质量分数约70%,蛋白质质量分数约20%)能较好地保持戊聚糖的特性.研究了其它添加剂(卡拉胶)对戊聚糖的乳化性,戊聚糖对肉制品持油、持水性以及其质构的影响.谷朊粉废弃水提取物与卡拉胶的复配产品在添加量(质量分数)为6%时能使肉制品有较好的持油性和相应的质构. 相似文献
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Objective To investigate the effects of hypervolemic hemodilution (HH) with hypertonic saline plus hetastarch solution 40 injectio on hepatic ischemia-reperfusion (I/R) injury in rats. Methods Thirty male Wistar rats weighing 300-350 g were randomly divided into 3 groups ( n = 10 each): group I sham operation (group S); group II I/R and group Ⅲ HH. Partial liver ischemia was produced by clamping hepatic portal vein and left arteria hepatica for 30 min with atraumatic mini-clamp, followed by 2 h of reperfusion in I/R group and HH group. In HH group the animals were infused hypertonic saline plus hetastarch solution 40 injectio 10 ml/kg through vena caudalis over 30 min and then hepatic I/R was performed IS min after the infusion.The animals were killed at 2 h of reperfusion. The left liver was removed and blood sample was taken from inferior caval vein for determination of (1) serum alanine amino transferase (ALT) and aspartate amino transferase (AST) activities; (2) superoxide dismutase ( SOD) activity and malondialdehyde ( MDA) content in the liver; ( 3 ) microscopic examination. Results The serum ALT and AST activities and MDA content in the liver were significantly higher, SOD activity in the liver significantly lower after hepatic I/R and pathological changes in the liver severer in group I/R and HH than in group S. The serum ALT and AST activities and MDA content in the liver were significantly lower, SOD activity in the liver significantly higher after hepatic I/R and pathological changes in the liver milder in group HH than in group I/R. Conclusion Hypervolemic hemodilution with hypertonic saline plus hetastarch solution 40 injectio can ameliorate hepatic I/R injury by decreasing oxygen free radical production in rats. 相似文献