不同剂量羟乙基淀粉对全身麻醉患者凝血功能和血流动力学的影响

Effect of Different Dosages of Hydroxyethyl Starch on Coagulation Function and Hemodynamics in Patients Undergoing General Anesthesia

关键词:  全身麻醉  羟乙基淀粉  凝血功能  血流动力学

Key words:  general anesthesia  hydroxyethyl starch  coagulation function  hemodynamics

摘要:

目的 探讨不同剂量羟乙基淀粉200/0.5氯化钠对全身麻醉患者凝血功能和血流动力学的影响。方法 选入2014年10月-2017年10月浙江省德清县人民医院收治的行手术治疗的全麻患者118例，根据羟乙基淀粉200/0.5氯化钠剂量分为小剂量组（10 mL·kg^-1）和大剂量组（20 mL·kg^-1），每组59例，监测2组的凝血功能及血流动力学变化，并进行统计比较。结果 2组患者在不同时间凝血功能指标（凝血酶原时间、活化部分凝血活酶时间、血小板计数和纤维蛋白原）及血流动力学指标（心率、中心静脉压、平均动脉压和外周血管阻力）均无明显差异。结论 全麻诱导前输注10，20 mL·kg^-1羟乙基淀粉200/0.5氯化钠均能使术中血流动力学维持稳定状态，且对凝血功能的影响很小。

Abstract:

OBJECTIVE To investigate the effect of differnet dosages of hydroxyethyl starch 200/0.5 sodium chloride on coagulation function and hemodynamics in patients undergoing general anesthesia. METHODS One hundred and eighteen patients with general anesthesia who underwent surgical treatment in Deqing People's Hospital from October 2014 to October 2017 were enrolled and divided into small dose group (10 mL·kg^-1) and high dose group (20 mL·kg^-1) according to the dose of hydroxyethyl starch 200/0.5 sodium chloride(n=59). The coagulation function and hemodynamic changes were compared between the two groups. RESULTS There were no significant differences in coagulation function indexes (prothrombin time, activated partial thromboplastin time, blood platelet and fibrinogen) and hemodynamic indexes (heart rate, central venous pressure, mean artery pressure and systemic vascular resistance) between the two groups at different time points. CONCLUSION Infusion of 10, 20 mL·kg^-1 hydroxyethyl starch 200/0.5 sodium chloride before induction of general anesthesia can effectively maintain intraoperative hemodynamic stability effectively, and has little effect on coagulation function.