术中输注大剂量贺斯对消化道肿瘤患者凝血功能的影响

Effect of infusion great dosage HAES-Steril during operation on the blood coagulation function of alimentary tract tumor patients

摘要: 目的　观察大剂量、长时间输注 6 %贺斯对消化道肿瘤患者凝血功能的影响。方法　选择 30例术前ASAI II级消化道肿瘤患者, 入室后抽取静脉血作对照 (T0 ), 当术中失血量约占总血容量 2 0 %～ 30%, 采用 6 %贺斯补容。术中失血量占总血容量 30 %以上时采用不同比例浓缩红细胞与 6 %贺斯快速扩充血容量。分别在输入不同剂量的 6 %贺斯时抽取静脉血监测APTT、PT、TT、PLT、PCT、MPV及PDW等。结果　当输入 6 %贺斯 2 0 0 0ml时APTT、PT、TT延长 (P <0 .0 5 )但均在正常生理范围内。PLT、PCT、MPV等下降, 但也均在正常生理范围内。HCT下降 2 3.2 6 % (P <0 .0 1), 但HCT >0 .2 5。麻醉过程中血流动力学平稳, 尿量满意。结论　对消化道肿瘤患者在有完备的监测、控制手段下大剂量、长时间输注贺斯对患者的凝血功能影响轻微。

Abstract: Objective To observe the effect of infusion great dosage HAES-Steril for a long time on the blood coageulation function in the alimentary tract tumor patients. Methods Selected thirty alimentary tract tumor patients of ASA I-II before operation, collected their venous blood to make contrast after entered the operating-room .During the operation, when the blood loss volume reached 20%～30% of the total blood volume, adopted 6% HAES-Steril to expand the blood volume, when the blood loss beyonded 30%, ...