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《Practical Journal of Medicine & Pharmacy》 2010-01
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Effect of acute hypervolemic hemodilution on body internal environment homeostasis:Comparative study on different agents

LI Qian-hui,WANG Ling,WU Qing-hua,et al.Dept.of Anesthesia,No.150 Hospital,Luoyang,Henan 471031,China  
Objective To compare the effects of acute hypervolemic hemodilution by Lactated Ringer's solution、6% Hydroxyethyl Starch130/0.4 and 4% Succinylated Gelatin on body internal environment homeostasis.Method Thirty patients undergoing scheduled meningioma operation were randomly divided into 3 groups:Group Ⅰ(AHHD with lactated Ringer's solution),Group Ⅱ(AHHD with 6% hydroxyethyl starch 130/0.4),Group Ⅲ(AHHD with 4% succinylated gelatin),with 10 in each group.AHHD was performed by infusing 20 ml/kg·h solution 30 minutes before induction and infusing 20 ml/kg·h solution 30 minutes during and after induction,then the operation was performed.The venous blood samples were collected before AHHD(T1),at the end of AHHD(T2),60 minutes after AHHD(T3),120 minutes after AHHD(T4)respectively for determining HCT,HB,PT,TT,APTT,FBG,Ⅷ,VWF and β2-MG;arterial blood samples before AHHD(T1),at the end of AHHD(T2),60 minutes after AHHD(T3),120 minutes after AHHD(T4)were respectively collected for determining blood gas and electrolytes.Result In changes of HCT,HB there were significant differences between after AHHD and before AHHD(P0.01);in changes of PT,TT,APTT,FBG,Ⅷ,VWF there were significant differences between after AHHD and before AHHD(P0.05),and TT,FBG,Ⅷ,VWF were all at the normal level,but PT,APTT were beyond the normal level;in changes of APTT there were significant differences between group Ⅱ,Ⅲ and groupⅠ(P0.01).In changes of β2-MG,compared with T1,there were no significant differences at T2,T3,T4(P0.05);in changes of pH and K+,compared with T1,there were no significant differences at T2,T3,T4(P0.05),compared with T1,HCO3-,PaCO2 decreased significantly after AHHD(P 0.01).Compared with T1,Na +,Cl-increased significantly at the end of AHHD(P0.01);Ca2+ decreased significantly at the end of AHHD in group Ⅱ and group Ⅲ(P0.01).Conclusion AHHD before operation can maintain stable hemodynamics;AHHD with 6% hydroxyethyl starch 130/0.4 and 4% succinylated gelatin have effects on blood coagulation,but no clinical hemorrhagic signs increased.AHHD with 6% hydroxyethyl starch 130/0.4 and 4% succinylated gelatin have no determental effects on renal function in patients with normal function.AHHD has no significant effect on the analysis of blood gas;After AHHD Cl-increased in three groups,and Ca2+ decreased in groupⅡ and groupⅢ,which attentions should be taken and supplement of Ca2+ is necessarily given.
【CateGory Index】: R614
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