不同剂量中分子羟乙基淀粉对急性脑出血手术病人血液流变学及凝血功能的影响

目的：观察应用不同剂量中分子羟乙基淀粉对急性脑出血手术病人血液流变学和凝血功能的影响。方法60例急性脑出血手术的患者随机分为4组，各15例。 A组贺斯10ml/kg，B组贺斯15ml/kg，C组贺斯20ml/kg，D组为对照组，采用平衡液15ml/kg输液治疗。测定指标：血球压积、全血黏度（高、中、低切变率时）、血浆黏度；凝血酶原时间（PT）、激活部分凝血活酶时间（APTT）、纤维蛋白原浓度（FIB）；记录生命体征、尿量及出血量。结果4组患者输液前全血黏度、血浆黏度及血球压积均明显增高，通过输液治疗后均有所降低，而以C组治疗效果最为显著。6%羟乙基淀粉能降低延长APTT时间，但仍在正常范围内。结论临床输注中分子羟乙基淀20ml/kg能明显改善急性脑出血患者血液流变学，同时对凝血功能无明显影响。

The effects of different doses of medium molecular hydroxyethyl starch infusion on blood rheology and coagulation in surgical patients with acute cerebral hemorrhage

Objective To observe the effects of different doses of medium molecular hydroxyethyl starch （HES） infusion on blood rheology and coagulation in surgical patients with acute cerebral hemorrhage. Methods 60 surgical patients with acute cerebral hemorrhage were randomly divided into 4 groups,group A were infused with HES 10mg/kg （n=15）,group B were infused with HES 15mg/Kg（n=15）,group C were infused with HES 20mg/kg（n=15） and group D which was control group were infused with balanced salt solution 15ml/kg（n=15）. Detect the following indicators： hematocrit（HCT）,blood high,middle,low shear rate viscosi-ty,plasma viscosity,prothrombin time （PT）,activated partial thromboplastin time （APTT）,fibrinogen concentration （FIB）;the vital signs,urine and bleeding amounts were recorded. Results The blood viscosity,plasma viscosity and HCT in 4 group was signifi-cantly increased before infusion,which was decreased in different extent after infusion therapy,and group C had the best therapeu-tic effect compared with the other 3 groups. 6%HES can prolong APTT time,but still within the normal range. Conclusion Infu-sion of HES in clinical 20ml/kg can significantly improve blood rheology in surgical patients with acute cerebral hemorrhage ,but dose not affect the activity of blood coagulation.