HHS40对止血带诱导的血浆血管性假性血友病因子变化

目的探讨高渗氯化钠羟乙基淀粉40注射液（HHS40）对止血带引起的血浆血管性假性血友病因子（vWF）含量变化。方法将20例ASAI-Ⅱ级择期全麻行单膝关节置换手术的患者分为两组,即高渗氯化钠羟已基淀粉40注射液组（n=10）,对照组（n=10）。检测止血带充气前及放气后0、5、10、20 min血浆vWF的含量。结果对照组患者血浆vWF含量在放止血带即刻0 min较HHS40组明显升高,对照组放止血带后10 min降到最低,放止血带后20 min逐渐恢复。HHS40组放止血带后vWF含量5 min后降至最低,放止血带后10、20 min逐渐恢复正常,两组比较差异无统计学意义（P〉0.05）。结论全麻下行下肢骨科手术止血带对患者血浆vWF有一定影响,HHS40组和对照组比较可降低vWF的含量。

Effect of hypertonic sodium chloride hydroxyethyl starch 40 injection on tourniquet-induced changes in levels of serum vWF

Objective To investigate the influence of hypertonic sodium chloride hydroxyethyl starch 40 injection on the tourniquet-induced changes in serum vWF levels.Methods 20 ASA I-Ⅱcases who undergo selective TKR（total knee replacement） under general anesthesia were randomly divided into HHS40 group（n=10） and control group（n=10）.vWF were respectively measured before inflation and 0,5,10,20 minutes after deflation of tourniquet.Results In comparison with pre-inflation of tourniquet,vWF in control group increased after deflation and gradually decreased at 5 minutes,recovered at 10 and 20 minutes after deflation.vWF in HHS40 group started to decrease at 5 minutes after deflation and gradually recovered at 10 to 20 minutes after deflation.vWF in 2 groups did not have statistical difference at each time point（P0.05）.Conclusion During lower extremities surgery under general anesthesia,tourniquets have a certain effect on the serum vWF.The greatest effect happens within 5-10 minutes after deflation.vWF is decreased in HHS40 group compared with that in control group.