剖宫产术前急性高容量血液稀释对产妇高凝状态的影响.pdfVIP

临床麻醉学杂志 2008 年 3 月第 241盟第 3 期 J Clín Anesthesíol.March 2008. Vol. 24.No. 3 ? 205 ? ? I临床研究· 剖宵产术前急性高容量血液稀释对产妇 高凝状态的影响 梁桦黄琼义先点张亚军李但杨承祥 E摘要3 阔的 观察混乙荔淀粉(HES)术前急性商容量血液稀释(AHHD)对削宵产产妇商凝 状态的影响，方法 择期行剖宫产的产妇 40 例，随机均分为两组。术前 30 min 内输垃 15 ml/kg HES 200/0. 旧日组)或发方乳酸销(RL)(R 组)。抽取静脉血标本，采用血栓弹力描记仪检测麻醉前 (To ) 、AHHD 结束厨即刻tl (Tl ) ,1 h(Tz ) 、 4 h(T3 )时的凝lúI.状态。结果 与 To 比较 ， H 组与 R 组产妇 的丁EG 参数民值在 T1时明显延长(P0.05);H 组的丁在G 参数 ANG、MA、CI 在 1 、Tz 、飞时明援 减小(PO.O日 .R 组仅在一r3 时明显增加(P0.05). 与民组比较，H 绕在 T1-Ts 时的丁EG 参数 ANG、MA、CI 明显减小(PO.O日，结论 剖宫产术前采用 HES 200/0. 5 行AHHD能减轻剖宫产 囤术期产姻的高凝状态，对预防术后静脉血栓形成可能有一定的作用. 【关键诩】 报乙基提粉;血液稀释 p高凝状态;剖宵产水 Effect of acute hypervolemic hemodilution on hypercoagulability of patients undergoing ce喔arean 锦ction LlANGH，ω ? HUANG Qiong , WEN Xi翩翩jíe , et al. Department of Anesthesiology ? Affiliated Foshan Hospital of Sun Yat-Sen Universíty ,Foshan 528000. China [Abstract] Objective To investigate the effect of acute hypervolemic hemodilutíon (AHHD) wíth 6 % hydroxyethyl starch (HES) on the hypercoagulable state of patients undergoing cesarean section. Meth创s Forty women with hypercoagulable state undergoing e1ective cesarean section were randomly divided into two groups with 20 cases each. 15 ml/kg of HES (group H) and or lactated Rínger s solution (group R) was ínfused within 30 min before surgery. Coagulation function was assessed by thrombelastography (TEG) analyzer before AHHD(To) .at the end of AHHD(T1 ) .at 1 h (Tz) and 4 h after the end of AHHD (丁3) R郎ults The parameter R of TEG was increased significantly in HES and group R at T1 as compared to that at 丁。 (PO.O日. The ANG ,MA and CI were decrωsed significant1y after AHHD as compared to those at To in HES group (P O. 05). Compared with group R. the ANG. MA and CI of HES group were significantly lower after AHHD (PO.O日.丁he ANG ,MA and CI were increased significant1y at T3 as compared to those at To in RL group(PO. 0日. Conclusion AHHD with HES 200/0.5 can allevíate the hypercoagulability of patients undergoi