首都医科大学学报 ›› 2005, Vol. 26 ›› Issue (6): 749-751.

• 临床研究 • 上一篇    下一篇

缩合葡萄糖氯化钠用于扩容性血液稀释对凝血功能及电解质的影响

王会文, 梁辉, 吉勇, 王保国   

  1. 首都医科大学附属北京天坛医院麻醉科
  • 收稿日期:2004-09-16 修回日期:1900-01-01 出版日期:2005-12-24 发布日期:2005-12-24

Alterations of Coagulation Function and Electrolytes During Hypervolemic Hemodilution with Polyglucose and Sodium Chloride Infusion

Wang Huiwen, Liang Hui, Ji Yong, Wang Baoguo   

  1. Department of Anesthesiology, Beijing Tiantan Hospital, Capital University of Medical Sciences
  • Received:2004-09-16 Revised:1900-01-01 Online:2005-12-24 Published:2005-12-24

摘要: 目的 对比观察缩合葡萄糖氯化钠溶液和6%羟乙基淀粉溶液用于扩容性血液稀释期间凝血功能及电解质的变化。方法 24例颅脑手术病人,随机分为缩合葡萄糖氯化钠溶液组(Ⅰ组)和6%羟乙基淀粉组(Ⅱ组),麻醉诱导后分别用相应液体以25mL/min的速度扩容。分别于麻醉诱导后、输液500mL1、000mL、1500mL及完成扩容后30min时,测定红细胞比容(HCT)、血小板计数(PLT)、活化部分凝血活酶时间(APTT)、血浆凝血酶原时间(PT)、血清电解质水平、血糖(Glu)浓度等参数,并记录尿量。结果 输入1500mL后,Ⅰ组HCT降低21.5%,Ca2+浓度降低16.7%,APTT和PT分别延长12.1%和15.5%。Ⅱ组HCT和Ca2+分别降低27.3%和12.5%,APTT和PT分别延长21.4%和16.3%。结论 等容量输入缩合葡萄糖氯化钠溶液和6%羟乙基淀粉溶液用于扩容性血液稀释时,血液稀释程度前者弱于后者;对于凝血系统的影响后者大于前者。

关键词: 血液稀释, 凝血功能, 电解质, 羟乙基淀粉

Abstract: Objective To compare the alterations of coagulation function and electrolytes during hypervolemic hemodilution induced by polyglucose and sodium chloride infusion(groupⅠ) and 6% hydroxyethyl starch(groupⅡ).Methods 24 neurosurgical patients were randomly allocated into two groups.Hypervolemic hemodilution was induced by rapid infusion(25 mL/min) with PG(groupⅠ, n=12), 6% HES(group Ⅱ, n=12) after general anesthesia.Hematocrit(HCT), activate partial thromboplastin time(APTT), prothrombin time(PT) and serum electrolytecalcium concentrations were determined in whole procedure.Results After(1500) mL PGwas injected, HCTdecreased by 21.5%, Ca2+ decreased by 16.7% while APTT, PTincreased by 12.1% and(15.5)% respectively.After 1500 mL HESwas injected HCTdecreased by 27.3%, Ca2+ decreased by 12.5% but APTT, PTincreased by 21.4% and 16.3% respectively.Conclusion The hemodilution effects of polyglucose and sodium chloride infusion on coagulation and electrolytes are weaker than the effects of 6% hydroxyethyl starch.However, the coagulation function of 6% HESis stronger than that of PG.

Key words: hypervolemic hemodilution, coagulation, electrolyte, hydroxyethyl starch

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