6％羟已基淀粉130／0．4体外循环预充对心脏手术患儿肝肾功能及凝血功能的影响

目的探讨6％羟乙基淀粉130／0．4（6％HES130／0．4）体外循环（cardiopulmonary bypass，CPB）预充对心脏手术患儿肝肾功能及凝血功能的影响。方法40例CPB行心脏直视手术的患儿，性别不限，年龄≤6岁，随机分为实验组（6％HES130／0．4预充，n=20）和对照组（血浆预充，n=20）。分别于术前一日（110）及手术结束时即刻（T1）取患儿静脉血2ml分别装入两个试管送生化室检测患儿的丙氨酸氨基转移酶（ALT）、总胆红素（TBIL）、尿素（UREA）、肌酸酐（CREA）、凝血酶原时间（PT）、活化部分凝血活酶时间（APTT）、凝血酶时间（TT）、纤维蛋白原（Fbg）。结果与对照组比较，实验组ALT、TBIL、CREA明显下降（P〈0．05），PT、APTT明显延长且Fbg明显降低（P〈0．05）。结论CPB预充6％HES130／0．4对心脏手术患儿的肝肾功能无损伤，而有保护作用，对凝血功能有影响，但未见临床明显出血。

The Effects of Using Hydroxyethyl Starch 130/0.4 or Plasma in Cardiopulmonary Bypass Priming solusion on Hepatic-Renal Function and Coagulation

OBJECTIVE To evaluate the effect of hydroxyethyl starch 130/0.4 （HES） used as priming solution for cardiopulmonary bypass CPB） on hepatic -renal function and coagulation in infants undergoing cardiac surgery. METHODS Forty infants of either sex, aged ≤6yr undergoing cardiac surgery with CPB were randomly divided into 2 groups （n =20 each） ： HES group and plasma group. Blood samples were taken from the vein at one day before surgery （TO） and at the end of operation （ T1 ） for ALT, TBIL, UREA, Creatinine （ CREA）, PT, APTT, TT, Fbg monitoring. RESULTS The serum ALT, TBIL, CREA levels were significant lower in HES group than in plasma group （ P 〈 0.05 ）. The PT, APTT were significant longer and the Fbg were significant lower in HES group than in plasma group（ P 〈 0.05 ）. CONCLUSION Using HES 130/0.4 as priming fluid for CPB had not side effect on hepatic - renal function and had beneficial effects. HES 130/0.4 had some side effects on coagulation, but did not induce bleeding obviously in clinical.