万汶用于体外循环对凝血功能的影响

目的 观察万汶和贺斯在体外循环(CPB)手术中对凝血功能的影响,明确万汶在体外循环中的应用价值.方法 选择40例先天性心脏病纠治术的患者,随机分为万汶组20例(A组)和贺斯组20例(B组)分别将2种胶体用于CPB预充液,术中监测心率(HR)、平均动脉压(MAP)、中心静脉压(CVP),并监测CPB前30 min和CPB后60min的红细胞压积(HCT)、血浆凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、纤维蛋白原(Fib).结果 CPB后60min 2组PT均无明显变化(P＞0.05);APTT较体外循环前延长,且2组比较差异显著(P＜0.05);Fib均低于CPB前(P＜0.05),2组间差异无统计学意义(P＞0.05).结论 适量万汶和贺斯应用于CPB作为预充液一部分,对血流动力学和凝血功能均无明显影响,且万汶对机体凝血功能影响更小,是目前用于CPB的较好的新一代血浆代用品.

The Effect of voluven and HES on coagulation in the operation of cardiopulmonary bypass

Objective To observe the effect of voluven and HES on coagulation in patients who were operated by cardiopulmonary bypass(CPB),and to evaluate the application value voluven in cardiovascular surgery.Methods Forty patients undergoing open heart surgery were divided into two groups.The patients in group A were treated by voluven for primin gand volume replacement before and during CPB;the patients in group B were treated by HES for primin gand volume replacement before and during CPB.The hemodynamic data and coagulation function(HCT,PT,APTT,FIB) were measured in both groups 30 minutes before CPB and 60 minutes after CPB respectively.Results After CPB,there was no significant change in the prothrombin time(PT) between two groups.The activated partial thromboplastin time(APTT) of the two groups after CPB was longer than that before CPB(P<0.05),and there was a significant difference between the two groups.Fibrinogen concentrations(FIB) of the two groups after CPB were lower than those before CPB(P<0.05),but there was no significant difference between two groups in term of FIB(P>0.05).Conclusion Voluven and HES have no significant effects on hemodynamics and coagulation function,which can be used in cardiac surgery CP,however,voluven seems to have less effect on coagulation.