6%羟乙基淀粉行急性超容血液稀释对血电解质及酸碱平衡的影响.doc

6%羟乙基淀粉行急性超容血液稀释对血电解质及酸碱平衡的影响
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作者:张明军,韩晗,邱丽琳,蒋秋蓉,金淑君
【摘要】目的探讨6%羟乙基淀粉溶液(HES,200/)行急性超容血液稀释(AHHD)对机体血电解质及酸碱平衡的影响。方法选择20例20~40岁、ASAⅠ~Ⅱ级择期五官科手术插管全麻患者,以6%HES15 ml/kg 扩容行中度血液稀释。于AHHD前、AHHD后、手术结束时测定Hct、Hb、血电解质及酸碱平衡指标进行比较。结果 AHHD后、手术结束时Hct、Hb较AHHD前显著降低,AHHD后Hct、%%,达到中等程度血液稀释状态;AHHD后血K+%,血Ca2+%,但均在正常范围内;AHHD前、后pH值及血Na+浓度变化差异均无统计学意义。结论 6%HES溶液行AHHD能有效地使Hct及Hb下降至靶水平,同时维持了机体血电解质的稳定及酸碱平衡,是一种安全有效的AHHD方法。
【关键词】急性超容血液稀释;血浆代用品;血液成分
Abstract: Objective To investigate the effect of acute hypervolemic hemodilution (AHHD) with 6% of HES on blood electrolytes and acid-base Twenty patients (ASA
Ⅰ-Ⅱ, 20-40 years old) were selected and scheduled for ophthalmologic and otorhinolaryngologic operation under general anesthesia. They received 6% of HES (15ml/kg) for moderate hemodilution. Arterial blood samples were taken for determination of HCT, Hb, K+, Na+, Ca2+ and pH before and after AHHD, and at the end of surgical HCT and Hb significantly decreased after AHHD. HCT and Hb descended respectively by % and %, which reached the state of moderate hemodilution. K+ and Ca2+ after AHHD were decreased by % and %, respectively, but within mormal limits. The variation of pH and Na+ before and after AHHD had no statistic AHHD with 6% of HES can