论文部分内容阅读
目的:观察国产羟乙基淀粉急性等容血液稀释对异位妊娠手术患者肾功能的影响。方法:将72例异位妊娠患者随机分为观察组和对照组,每组36例。2组均于麻醉诱导后、手术前采集自体血至储血袋,然后分别静脉输注等体积的国产、进口羟乙基淀粉130/0.4,自体血于术中或术后输注。检测2组患者术前、术中自体血回输前、术毕时血红蛋白(Hb)、血细胞压积(Hct)、凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、凝血酶时间(TT)及术前、术后24h及48h的β2微球蛋白(β2-MG)、血尿素氮(BUN)及血肌酐(Cr)等肾功能指标。结果:(1)与术前比较,2组自体血回输前、术毕时Hb、Hct均有一定下降(P<0.05),尤其在自体血回输前下降明显,但仍在正常范围内。2组各时点Hb、Hct比较差异无统计学意义(P>0.05)。2组自体血回输前、术毕时PT、APTT、TT与术前比较无明显变化(P>0.05)。(2)与术前比较,2组术后24h及48h的β2-MG、BUN及Cr水平无明显变化(P>0.05)。2组各时点β2-MG、BUN及Cr水平比较差异无统计学意义(P>0.05)。结论:国产羟乙基淀粉作为扩容剂应用于急性等容血液稀释对肾脏功能影响较小,安全性较高。
Objective: To observe the effect of domestic hydroxyethyl starch acute normovolemic hemodilution on renal function in ectopic pregnancy patients. Methods: 72 cases of ectopic pregnancy were randomly divided into observation group and control group, 36 cases in each group. After induction of anesthesia, blood samples were collected from blood donors and blood storage bags before operation. The rats were then infused with equal volumes of homemade hydroxyethyl starch 130 / 0.4, and autologous blood was infused intraoperatively or postoperatively. The levels of hemoglobin (Hb), hematocrit (Hct), prothrombin time (PT), activated partial thromboplastin time (APTT), thrombin (TT) and β2-MG, BUN and Cr levels were measured before and 24 hours and 48 hours after operation. Results: (1) Before and after autologous blood transfusion, the levels of Hb and Hct decreased slightly (P <0.05), especially before autologous blood transfusion, but still within the normal range . There was no significant difference in Hb and Hct between the two groups at each time point (P> 0.05). There was no significant change in PT, APTT, TT before operation between the two groups before autologous blood transfusion (P> 0.05). (2) Compared with preoperative, the levels of β2-MG, BUN and Cr did not change significantly at 24h and 48h after operation (P> 0.05). There was no significant difference in the levels of β2-MG, BUN and Cr between the two groups at each time point (P> 0.05). Conclusion: The application of hydroxyethyl starch as a compatibilizer in acute normovolemic hemodilution has little effect on renal function and is safe.