羟乙基淀粉、血定安轻度扩容对冠脉搭桥患者心泵血功能、机体氧代谢的影响

目的:研究冠脉搭桥(CABG)手术患者输注羟乙基淀粉、血定安行高容血液稀释对血流动力学指标、氧代谢指标的影响。方法:120例冠心病拟行CABG手术患者,ASAⅡ～Ⅲ级,心功能Ⅱ～Ⅲ级。随机分成3组,即羟乙基淀粉组(Ⅰ:n=40);血定安组(Ⅱ:n=40);复方乳酸林格液组(Ⅲ:n=40)。麻醉诱导气管插管后,每组分别输注6%羟乙基淀粉、血定安、乳酸林格液8～10mL/kg,在30min内输注完毕。分别观察麻醉诱导前、插管后10min、血液稀释后30min和1h时心脏指数(CI)、每搏指数(SI)、左心室泵功(LVSWI)、右心室泵功(PVSWI)、外周循环阻力、肺血管阻力、肺动脉嵌压(PAWP)等血流动力学参数,氧供(DO2)、氧耗等氧代谢指标及血气的变化。结果:麻醉诱导后血流动力学指标较诱导前显著降低(P<0.05或P<0.01)。输注羟乙基淀粉、血定安后PAWP、CI、LVSWI、RVSWI、SI及DO2明显上升且显著高于组Ⅲ(P<0.05或P<0.01)。结论:经用羟乙基淀粉、血定安的轻度高容性血液稀释用于CABG手术患者可改善其麻醉后的心排出量和氧供需状态,羟乙基淀粉的近期效果可能优于血定安。

Effect of mild hemodilution by HAES or Gelofusin on hemodynamics and oxygen metabolism in patients undergoing CABG

Objective To explore the effect of hypervolemic hemodilution by HAES or Gelofusin on hemodynamics and oxygen metabolism in patients undergoing CABG. Methods 120 patients scheduled for CABG were randomly divided into 3 groups: HAES group (n=40), Gelofusin group (n=40) and Lactated Ringer′ s group (n=40). Their ASA and cardiac function were graded from Ⅱ to Ⅲ . The patients were then infused with 6% HAES, Gelofusin, and Lactated Ringer′ s solution 8～ 10 mL/kg respectively within 30 minutes after endotracheal ...