开胸手术中应用万汶对患者凝血功能和肾功能的影响

目的探讨在开胸手术中应用万汶对患者的凝血功能及肾功能的影响。方法选取自2009年2月-2011年2月来中山市人民医院行择期开胸手术的患者60例,随机分为对照组和观察组,每组30例。对照组给予静脉输注乳酸钠林格液,观察组输注万汶,观察记录两组患者各时点的红细胞压积(HCT)变化,术中、术后的凝血功能指标与肾功能指标的变化,及术后胸腔引流量的情况。结果观察组患者的HCT值在T3～T5时间点显著低于对照组(P<0.05),观察组T2～T5时间点、对照组T2～T4时间点的HCT值均比同组T1时间点的数值明显降低(P<0.05);两组患者的凝血功能指标与肾功能指标在各时点的数值,组内及组间比较差异均无统计学意义(P>0.05);两组患者术后胸腔引流总量比较差异无统计学意义(P>0.05)。结论在开胸手术中使用万汶行轻度术前急性高容量血液稀释对患者的凝血功能及肾功能无明显影响。

Effects of Voluven on Coagulation and Renal Function in Patients with Thoracotomy

Objective To discuss the effects of voluven(hydroxyethyl starch in sodium chloride injection) on the effects of coagulation and renal function in patients with thoracotomy.Methods Sixty cases with elective thoracotomy selected from 2009 February to 2011 February in our hospital were randomly divided into control group and observation group,and each group had 30 cases.The control group was given intravenous infusion of lactated Ringer’s solution,while the observation group revived the infusion of voluven.The changes of hematocrit(HCT) at each time point,coagulation and renal function before and after the treatment and the pleural drainage after the treatment were recorded.Results The HCT at the time point of T3-T5 in the observation group was lower than the control group(P<0.05);the HCT at the time point of T2-T5 and T2-T4 in both of the two groups were lower than the time point of T1 in the same groups(P<0.05).There were no significant differences in coagulation and renal function at each time point in groups and between groups(P>0.05);there was no significant differences in total amount of chest drainage after the treatment between the two group(P<0.05).Conclusion There is no obvious effect to coagulation and renal function by using voluven for mild preoperative acute hypervolemic hemodilution(AHH) in patients with thoracotomy.