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[1]刘 斐,孟尽海,吴 燕,等.羟乙基淀粉对全麻下行结直肠癌手术患者凝血功能的影响[J].宁夏医科大学学报,2013,(11):1219-1222.
 LIU Fei,MENG Jinhai,WU Yan,et al.The Effects of Hydroxyethyl Starch on Coagulation Function in Patients Performed Colorectal Cancer Surgeries[J].Ningxia Medical University,2013,(11):1219-1222.
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羟乙基淀粉对全麻下行结直肠癌手术患者凝血功能的影响(PDF)
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《宁夏医科大学学报》[ISSN:1005-8486/CN:64-1029/R]

卷:
期数:
2013年11期
页码:
1219-1222
栏目:
论著
出版日期:
2013-11-20

文章信息/Info

Title:
The Effects of Hydroxyethyl Starch on Coagulation Function in Patients Performed Colorectal Cancer Surgeries
作者:
刘 斐1 孟尽海2 吴 燕1 王春生1 姚 杰1
1.宁夏医科大学研究生学院,银川 750004; 2.宁夏医科大学总医院,银川 750004
Author(s):
LIU Fei1 MENG Jinhai2 WU Yan1 WANG Chunsheng1 YAO Jie1
1.Clinical Medical College of Ningxia Medical University, Yinchuan 750004; 2.The General Hospital of Ningxia Medical University, Yinchuan 750004
关键词:
羟乙基淀粉凝血功能麻醉
Keywords:
hydroxyethyl starch coagulation function anesthesia
分类号:
R735.3+7; R614.2
DOI:
-
文献标志码:
A
摘要:
目的研究静脉输注不同剂量羟乙基淀粉(130/0.4)对结直肠癌手术患者凝血功能的影响。方法结直肠癌手术患者60例,按照静脉输注不同剂量羟乙基淀粉随机分为A、B、C三组,每组20例,分别静脉输注羟乙基淀粉10、15和20mL·kg-1。观察并记录扩容前(T0)、扩容结束后30min(T1)、扩容后3.5h(T2)的凝血酶原时间(PT)、活化部分凝血酶原时间(APTT)、纤维蛋白原(FIB)、血红蛋白、血小板计数(PLT)等指标。结果组内比较:与T0相比,三组PT值在T1时均有不同程度延长(P<0.05),C组在T2时PT值仍高于T0时(P<0.05);A、B组中APTT值在T1、T2时与T0时比较明显延长(P<0.05),C组在T1、T2时与T0比较差异无统计学意义;三组FIB值在T1、T2时均有不同程度减少(P<0.05);三组血红蛋白浓度在T1时均降低(P<0.05),C组在T2时血红蛋白浓度仍高于T0时(P<0.05);三组血小板计数在T1时均降低(P<0.05);A、B组在T2时较T0时明显降低(P<0.05);C组在T2时与T0比较差异无统计学意义。不同指标T1与T2比较及各组组间比较差异均无统计学意义。结论对于结直肠癌手术患者,术中输入羟乙基淀粉会较小程度改变凝血功能参数,但均在正常范围之内,不同剂量的羟乙基淀粉对凝血功能无明显影响。
Abstract:
Objective To investigate the effects of hydroxyethyl starch(130/0.4)on coagulation function in patients performed colorectal cancer surgeries. Methods 60 aged patients were involved and randomly assigned to 3 groups according to different doses of hydroxyethyl starch they received: group A(10 mL·kg-1), group B(15 mL·kg-1), group C(20 mL·kg-1). Prothrombin time(PT), activated partial prothrombin time(APTT), fibrinogen(FIB), hemoglobin, platelet count(PLT)were monitored and recorded before the capacity, after the capacity 30 min(T1), 3.5 h(T2). Results Compared with T0, PT of the three groups were longer when the T1(P<0.05). Group C in the T2 values of PT was still higher than that when the T0(P<0.05). Group A and B values of APTT in T1, T2 with obvious extended when T0(P<0.05). Group C in comparison with T0,T1,T2 difference had no statistical significance. Three groups of FIB values in T1, T2 had varying degrees of reduced(P<0.05).Three groups of hemoglobin concentrations were lower at the time of T1 group C(P<0.05)while hemoglobin concentration in T2 was still higher than that when T0(P<0.05). Three groups of platelet count were lower at the time of T1(P<0.05). Conclusion For patients with colorectal cancer surgeries, less hydroxyethyl starch will change coagulation function parameters, but all within normal range. No different effect was found in different doses of hydroxyethyl starch.

参考文献/References:

[1] Sutherland DE, Weitz IC, Liebman HA. Thromboembolic complications of cancer:epidemiology, pathogenesis, diagnosis, and treatment [J]. Am J Hematol,2003,72(1):43-52.
[2] Luxembourg B, Bauersachs R. Malignancy and thrombosis:a double-sided clinical relationship [J]. Vasa, 2005,34(4):225-234.
[3] Prandoni P, Falanga A, Piccioli A. Cancer and venous thromboembolism[J]. Lancet Oncol,2005, 6:401-410.
[4] Ng JKF, Lam CCK, Chan LC. In vivo effect of haemodilution with saline on coagulation:a randomised controlled trial[J]. British Journal of Anaesthesia, 2009, 88:475-480.
[5] 惠晶, 史中华. 羟乙基淀粉急性扩容性血液稀释对凝血功能的影响[J]. 海南医学, 2010, 21(23):1-3.
[6] Liu Fu-chao, Liao Chang-hui, Chang Yao-wen, et al. Hydroxyethyl starch interferes with human blood revive coagulation, platelet function and sedimentation [J]. Acta Anaesthesiologica Taiwanica, 2009, 47(2):71-78.
[7] 赵砚丽, 张东, 霍树平. 两种羟乙基淀粉急性高容量血液稀释对患者凝血功能的影响[J]. 中华麻醉学杂志,2005, 25:716-718.
[8] 李君,张欢,杨拨贤.人工胶体用于急性高容量血液稀释对凝血功能的影响[J]. 临床麻醉学杂志, 2007, 23:6-8.
[9] Jamnicki M, Bombeli T, Seifert B, et a1.Low- and medium- molecular weight hydroxyethyl starches:comparison of their effect on blood coagulation[J]. Anesthesiology, 2000,93:1231-1237.
[10] Madjdpour C,Dettori N,Frascarolo P, et a1.Molecular weight of hydroxyethyl starch:is there an effect on blood coagulation and pharmacokinetics[J]. Br J Anaesth,2005,94(5):569-576.
[11] Huttner I,Boldt J, Haisch G,et a1.Influence of different colloids on molecular markers of haemostasis and platelet function in patients undergoing major abdominal surgery[J].Br J Anaesth,2000,85(3):417-423.
[12] 曾斌其, 黄维军.血液稀释技术临床研究进展 [J]. 右江民族医学院学报,2005, 20(3):397-399.

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备注/Memo

备注/Memo:
收稿日期:2013-05-30 基金项目:宁夏卫生厅重点科研课题(2011003) 作者简介:刘斐(1987-),女,河北人,在读硕士研究生。 通信作者:孟尽海,男,主任医师,教授,从事临床麻醉工作。
更新日期/Last Update: 2013-11-20