羟乙基淀粉溶液对腹腔镜胆囊切除患者血液流变学特性的影响

摘要/Abstract

摘要： 目的观察腹腔镜气腹及术中使用羟乙基淀粉130/0.4溶液对腹腔镜胆囊切除患者血液流变学特性的影响。方法 60名腹腔镜胆囊切除术患者于术前、建立气腹后、使用HES 130/0.4溶液（对照组使用林格氏液）后、术后四个时间点检测全血粘度（WBV）、血浆粘度（PV）、红细胞压积（HCT）、血沉（ESR）、血沉方程K值（ESR K）、红细胞刚性指数（RI）、红细胞聚集指数（EAI ）。结果建立气腹后患者WBV、PV、RI、EAI均较术前明显升高；使用HES 130/0.4溶液后，患者WBV、HCT、EAI、ESR K明显下降，治疗组较对照组下降幅度大；术后非老年患者指标恢复正常，但老年患者WBV、PV、HCT、EAI仍有升高。结论腔镜手术中气腹影响患者特别是老年患者血液流变学特性，而术中使用HES 130/0.4溶液可以有效降低血液粘度、改善微循环。

关键词: 羟乙基淀粉溶液, 气腹, 腹腔镜胆囊切除术, 血液流变学, 影响

Abstract: 【Abstract】 Objectives To investigate the effects of pneumoperitoneum and infusion with hydroxyethyl starch (HES) l30/0.4 solution intraoperation on hemorheological parameters of patients underwent laparoscopic cholecystectomy (LC). Methods Sixty patients underwent LC were taken blood sample for determination of hemorheology variables on the morning of the operation day , after pneumoperitoneum, after infusion with HES 130/0.4 solution (or the Ringer’s lactated solution) and the first morning after operation. The hemorheological parameters includs: WBV, PV, HCT, ESR, ESR K, RI, EAI. Results WBV, PV, RI, EAI increased significantly after pneumoperitoneum. After using HES 130/0.4 solution, WBV, HCT, EAI, ESR K of the patients decreased significantly, the treatment groups had more decreasing amplitude than the control groups. The non-elderly patients recovered on the first morning after operation, but WBV, PV, HCT, EAI of elderly patients are still higher. Conclusions The pneumoperitoneum can affect the hemorheological characters of patients(especially the elderly patients) underwent LC. Loading infusion HES 130/0.4 solution can lower the blood viscosity, ameliorate the microcirculation and decrease the occurrence of thrombosis complications.

Key words: Hydroxyethyl starch solution, Pneumoperitoneum, Laparoscopic cholecystectomy, Hemorheology, Influence

中图分类号:

R466.11+2

欧希刘晓平刘吉奎熊沛. 羟乙基淀粉溶液对腹腔镜胆囊切除患者血液流变学特性的影响[J]. 岭南现代临床外科, 2012, 12(02): 87-91.

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