CAJ | 학술논문

目的评价6%羟乙基淀粉130/0.4(6%HES 130/0.4)用于体外循环心脏外科手术患者的安全性.方法拟在体外循环下行心脏外科手术患者60例,年龄18～64岁,ASAⅡ或Ⅲ级,随机分为2组(n=30):HES组和4%琥珀酰明胶组(GEL组).术中HES组和GEL组分别静脉输注6%.HES 130/0.4和4%琥珀酰明胶7～12 ml·kg-1·h-1维持中心静脉压6～12 mm Hg和/或肺动脉楔压8～15 mm Hg体外循环预充液包括胶体液500～1000ml ICU 中 HES组和GEL组分别静脉输注6%HES 130/0.4和4%琥珀酰明胶60～120 ml/h.维持中心静脉压 6～12 mm Hg和/或肺功脉楔压8～15mm Hg 记求围术期血液动力学指标、红细胞压积,凝血功能指杯.肝、肾功能指标.液体出入量及不良反应的发生情况结果呐种胶体围术期平均用量都接近50 ml·kg-1·d-12组血液动力学,红细胞压枳、凝血功能指标、肝,肾功能指标.淑体出入量和小良反应发生率异无统汁学意义(P>0.05)结论围术期超大剂量6%HES 130/0.4(50ml·kg-1·d-1)可安全地用于体外循环心脏外科手术患者.
목적 평개6%간을기정분130/0.4(6%HES 130/0.4)용우체외순배심장외과수술환자적안전성.방법 의재체외순배하행심장외과수술환자60례,년령18～64세,ASAⅡ혹Ⅲ급,수궤분위2조(n=30):HES조화4%호박선명효조(GEL조).술중HES조화GEL조분별정맥수주6%.HES 130/0.4화4%호박선명효7～12 ml·kg-1·h-1유지중심정맥압6～12 mm Hg화/혹폐동맥설압8～15 mm Hg체외순배예충액포괄효체액500～1000ml ICU 중 HES조화GEL조분별정맥수주6%HES 130/0.4화4%호박선명효60～120 ml/h.유지중심정맥압 6～12 mm Hg화/혹폐공맥설압8～15mm Hg 기구위술기혈액동역학지표、홍세포압적,응혈공능지배.간、신공능지표.액체출입량급불량반응적발생정황결과눌충효체위술기평균용량도접근50 ml·kg-1·d-12조혈액동역학,홍세포압지、응혈공능지표、간,신공능지표.숙체출입량화소량반응발생솔이무통즙학의의(P>0.05)결론위술기초대제량6%HES 130/0.4(50ml·kg-1·d-1)가안전지용우체외순배심장외과수술환자.
Objective To evaluate the safety of volume replacement with 6% hydroxyethyl starch (HES) 130/0.4 in cardiac, surgery with eardiopulmonary bypass (CPB). Methods Sixty ASA Ⅱ orⅢ patients aged 18-64 yr undergoing cardiac surgery with CPB were randomly divided into 2 groups ( n = 30 each) : group 1 6% HES 130/0.4 (HES) and groupⅡ 4% succimyl gelatin (GEL). Priming solutions contained 6% HES 130/0.4 or 4% succinyl gelatin 500-1 000 ml. 6% HES 130/0.4 and 4% suecinyl gelatin were infused at 60-120 ml/h during operation to maintain CVP at 6-12 mm Hg and/or PCWP at 8-15 mm Hg in group HES and GEL respectively. Hemodynamic parameters, Hot, blood eoagulafiun were measured before, during and after operation. Hepato-renal function was measured before and after operation. Fluid balance and adverse reactions were recorded. Results The average amount of colloid approached 50 ml·kg-1·d-1in both groups. There were no significant differences in bemodynamics, Hct, blood coagulation parameters and hepato-renal function, fluid balance and adverse reactions between the two groups. Conclusion 6% HES 130/0.4 can be safely used for plasma volume replacement in cardiac surgery with CPB if the amount is less than 50 ml·kg-1·d-1.