羟乙基淀粉130／0．4对颈髓损伤患者凝血功能的影响

目的评价6％羟乙基淀粉130／0．4对颈髓损伤嗅鞘细胞移植患者凝血功能的影响。方法择期行嗅鞘细胞移植颈髓损伤患者40例，年龄18～49岁，体重49～88kg，ASIAⅡ或Ⅲ级，随机分为羟乙基淀粉130／0．4组（实验组）和复方氯化钠组（对照组），每组20例。麻醉诱导气管插管后吸入安氟醚维持麻醉。两组分别于气管插管后以10～15ml·kg^-1·h^-1的速率经上肢静脉输注6％羟乙基淀粉130／0．4、复方氯化钠25ml／kg。分别于输注前、输注完毕30min、4h时肘静脉抽血样，测定血红蛋白浓度（Hb）、血小板计数（Plt）、凝血酶原时间（PT）、激活部分凝血酶原时间（APTT）、纤维蛋白原浓度（Fib）。结果两组输注完30min、4h时Hb与Plt较输注前明显降低（P〈0．01）；两组输注前后PT、APTT、Fib差异无统计学意义（P〉0.05）。结论术中输注6％羟乙基淀粉130／0．4对颈髓损伤嗅鞘细胞移植患者凝血功能无明显影响。

Effects of hydroxyethyl starch 130/0.4 on blood coagulation function in the patients of cervical spinal cord injury for olfactory ensheathing cell transplantation

Objective To assess the effects of hydroxyethyl starch 130/0.4 on blood coagulation function in patients of cervical cord injury for offactory ensheathing cell transplantation. Methods Forty patients of cervical spinal cord injuries undergoing olfactory ensheathing cell transplantation were randomly assigned to one of 2 groups （n=20, each）.. Hydroxyethyl starch 130/0.4 group and Ringer＇s solution group. The patients were premedicated with in Phenobarbital 0.1g and atropine 0.5mg. Anesthesia was induced with etomidate 0.3mg/kg, fentanyl 4μg/kg and atracurium 0.5mg/ kg and maintained with enflurane and intermittent intravenous drip boluses of fentanyl and atracurium after tracheal intubation. Hydroxyethyl starch 130/0.4 or Ringer＇s solution 25ml/kg was infused after tracheal intubation at a rate of 10 - 15ml·kg^-·h^-1 throμgh venous line. Veous blood samples were taken before （T1, baseline） and at 30min （T2） and 4h （T3） after Hydroxyethyl starch 130/0.4 or Ringer＇s solution infusion for determination of hemoglobin （Hb）, platelet count （Pit）, prothrombin time （PT）, activated partial thromboplastin time （APTT） and fibrinogen level （Fib）. Results Hb and Plt were significantly decreased at T2 and T3 after Hydroxyethyl starch 130/0.4 or Ringer＇s solution as compared with the baseline values at T1 before infusion. There was no significant change in PT, APTT and Fib after infusion in both groups. Conclusion Infusion of Hydroxyethyl starch 130/0.4 25ml/kg during olfactory ensheathing cells transplantation does not have significant effects on blood coagulation function in patients of cervical spinal cord injury.