摘要:
Objective To explore the safety and feasibility of VOLUVEN and HES used for acute hyperv-olemic hemodilution on selective Hepatectomy .Methods 42 patients ( ASAⅠ ~Ⅱ) were randomized to the two groups(Ⅰ,VOLUVEN group;Ⅱ,HES group),20 minutes before the operation,the two groups of patients underwent AHH with VOLUVEN and HES respectively at the same quantity and speed ,and then the changes of haemodynamics , blood gas analysis ,electrolyte and coagulation indexes were detected .Results InⅠgroup,the changes of HB、HCT, PLT,central venous pressure had statistical significance before and after AHH (t=7.880,32.257,7.303,22.812,all P=0.000).InⅡgroup,the changes of HB,HCT,PLT,central venous pressure had statistical significance before and after AHH(t=5.398,14.924,11.171,5.620,all P=0.000).For inter-group,VOLUVEN has less effect than HES on central venous pressure(t=2.367,P=0.023).Conclusion Using VOLUVEN or HES can keep hemodynamics stable and improve the ischemic tolerance for AHH in liver surgery .VOLUVEN has less effect on central venous pressure.%目的:探讨中分子羟乙基淀粉130/0.4(万汶)与中分子羟乙基淀粉200/0.5(贺斯)用于择期肝脏手术患者行急性高容血液稀释( AHH)的安全性与可行性。方法选取42例ASAⅠ~Ⅱ级需行择期肝脏手术的患者,按随机数字表法分为两组( I组输万汶,II组输贺斯),于术前20 min分别用万汶和贺斯行急性高容血液稀释,输入量及速度都相同,检测患者术中血流动力学、血气分析、电解质及凝血功能等指标的变化情况。结果Ⅰ组AHH前后HB、HCT、PLT、中心静脉压差异均有统计学意义( t =7.880、32.257、7.303、22.812;P=0.000、0.000、0.000、0.000),II组AHH前后HB、HCT、PLT、中心静脉压差异均有统计学意义(t=5.398、14.924、11.171、5.620;P=0.000、0.000、0.000、0.000),两组之间比较,万汶对中心静脉压的影响较贺斯小(t=2.367,P=0.023)。结论在肝脏手术中采用万汶或贺斯施行急性高容血液稀释,可有效维持血流动力学平稳及提高对失血的耐受性,但万汶对中心静脉压的影响更小。