CAJ | 학술논문

背景羟乙基淀粉(hydroxyethylstarch,HES)是一种临床上广泛应用于容量替代和改善微循环的血浆代用品.以0.9%的NaCl溶液作为溶剂的HES,我们称之为非生理性的胶体,但过多的输入易导致高氯性酸中毒.近来,已研制出以复方电解质为溶剂的HES溶液,或可大大提高HES的安全性.目的此文回顾了HES的基本理化性质及HES的研发历程,并讨论了新型的以复方电解质为溶剂的羟乙基淀粉溶液在维持酸碱平衡、凝血和肾功能等方面的优势.内容越来越多的证据显示HES溶液与传统的HES相比,能够更好的维持酸碱平衡,对凝血功能的影响更小,在增加微循环灌注等方面也有独特的优势.此外,"生理性容量替代治疗"的初步研究结果也令人鼓舞.趋向以复方电解质为溶剂的胶体在临床将会得到更为广泛的应用,"生理性容量替代治疗"的策略也为临床提供了良好的思路.
배경 간을기정분(hydroxyethylstarch,HES)시일충림상상엄범응용우용량체대화개선미순배적혈장대용품.이0.9%적NaCl용액작위용제적HES,아문칭지위비생이성적효체,단과다적수입역도치고록성산중독.근래,이연제출이복방전해질위용제적HES용액,혹가대대제고HES적안전성.목적 차문회고료HES적기본이화성질급HES적연발역정,병토론료신형적이복방전해질위용제적간을기정분용액재유지산감평형、응혈화신공능등방면적우세.내용 월래월다적증거현시HES용액여전통적HES상비,능구경호적유지산감평형,대응혈공능적영향경소,재증가미순배관주등방면야유독특적우세.차외,"생이성용량체대치료"적초보연구결과야령인고무.추향 이복방전해질위용제적효체재림상장회득도경위엄범적응용,"생이성용량체대치료"적책략야위림상제공료량호적사로.
Background Hydroxyethylstarch (HES) is a widely used plasma substitute for correcting intravascular volume deficit and improving systemic hemodynamics as well as microcirculation. HES dissolved in isotonic saline may result in acid-base have been available. Purpose To review the chemical properties and the developing process of different generations of HES. The advantages of new balanced solutions over the unbalanced in acid -base status, coagulation and renal function are also discussed.Content Several studies demonstrated that such modern balanced HES preparations appeared to be safer with regard to acid-base balance, hemostasis, kidney function. Besides, the preliminary results in assessing the value of a total balanced volume replacement strategy including plasma-adapted HES solutions are quite promising. Trend The use of this new balanced HES will be widely Accepted in the future,and total balanced volume replacement strategy might be a pronising approach to further improves the safety of HES.