(血浆容量扩充药).ppt

体液组成成分 HES输入体内后，经淀粉酶不断分解，高分子量颗粒降解，中分子量颗粒增加，中分子量颗粒有效地发挥胶体渗透活性，维持血浆胶体渗透压。颗粒的分子量小于50000时很快经肾小球滤过排出，可改善肾脏灌注。 大于50000的HES颗粒 留在血管内继续发挥扩容的作用。 ● High Mw particle medium Mw particle amylase maintaining of COP degraded ● particles ﹤50,000 is filtrated from glomerulus improving perfusion of the kidney particles ﹥50,000 remain intrvescularly and exert its effect of volume expansion ● Hence, the duration of action of HAES and voluven is longer than that of 706 (4~8h:﹤2h) 因而 贺斯、万汶 扩容的有效时间长于706（4～8小时:＜2小时） 早期的高分子量、低分子量HES 或 高取代级的HES已被 中分子量中、低取 代级的HES（贺斯、万汶）所取代 Currently, HES of high Mw and High MS, like lamasteril (450/0.7), has already been obsolate . HAES of medium Mw, medium MS and voluven of medium Mw, low MS are the most popularly used HES for plasma replacement 二 HES的体内过程 2 The process of HES in the body 晶体液能通过毛细血管内膜自由移动， 输入的晶体液在2小时内80％转移到血管 外（即输入1000ml , 只剩 200ml ） Crystalloid fluid can pass through capillary endothelium freely. After 2h, only 20% of the infusion is still remaining in the circulation 而 6％贺斯 的血浆增量效力为 100％ [（实际血浆增加量／输入量）×100％ ，即，如输入1000ml, 血容量较输注前增加1000ml ], 以后维持4小时， 8小时后仍有 72％ 的扩容量，至24h还保持285ml， 故有很好的扩容效应 Plasma expansion effect of 6% HAES is 100% [ (increased plasma volume/infused volume) X 100%, i.e. after giving 1000ml, blood volume is 1000ml more than that before infusion ] 100% of expanded volume remains in the circulation for 4 h , 72% after 8h and 28% after 24h diluted diluted abnormal coagulation blood (血 液) low low high anaphlactic reaction (变态反应) 3h 3－4h 20 days T1/2 (半衰期) 4h 4-8 h 1 h duration of effect (时 效) 130～100％ 100 % 50 % effect of vol. expansion (扩容效力) 6％ 6％，10％ 6％ Con.