摘要
目的探讨神经外科手术中使用高渗氯化钠羟乙基淀粉40注射液(以下简称:高渗晶胶液)对患者凝血功能、电解质和血糖的影响。方法选择ASAⅠ-Ⅱ级,神经外科手术患者20例,所有患者均采用静吸复合麻醉。入室后局麻下行桡动脉及颈内静脉穿刺,以5ml/kg输注高渗晶胶液,30-45min内输注完毕,输注后行麻醉诱导。分别在输注高渗晶胶液前(T0)、输注高渗晶胶液完毕即刻(T1)、输注高渗晶胶液后30min(T2)、60min(T3)、术后30min(T4)监测:(1)心率(HR)、平均动脉压(MAP)、中心静脉压(CVP)、血氧饱和度(SpO2)等;(2)凝血酶原时间(PT)、部分凝血活酶时间(APTT);(3)血清K+、Na+、Ca2+、Hct、Hb及血糖。结果与T0时相比,CVPT3时明显升高(P<0.05);APTT、PTT1时开始增加(P<0.05),T2时达到高峰(P<0.05),T3时恢复正常;输注高渗晶胶液后K+浓度降低,Na+浓度升高,T1时改变最为明显(P<0.05),T3时基本恢复基础值;Hct、Hb随着输注液体的增加逐渐降低,与T0时相比差异有统计学意义(P<0.05);各时点血糖差异无统计学意义(P>0.05)。结论适量输入高渗晶胶液(5ml/kg)对神经外科手术患者术中凝血功能和电解质、血糖无明显影响。
Objective To explore the effect of hypertonic saline hydroxyethyl starch 40 injection on blood coagulation and electrolyte,blood glucose in nerve surgery.Methods 20 patients with ASAⅠ-Ⅱgrade were performed neurological surgery under the inhalation anesthesia.5ml/kg hypertonic crystal glue had been infused via radial artery and jugular vein for 30-45min,then induction of anesthesia was performed.Many parameters,such as heart rate （HR）,mean arterial pressure （MAP）,central venous pressure （CVP）,oxygen saturation （SpO2）;prothrombin time （PT）,partial thromboplastin time （APTT）;serum K＋,Na＋,Ca2＋,Hct,Hb and blood sugar,were monitored at some time points as followed：before the crystal glue infusion （T0）,after crystal glue infusion immediately （T1）,after crystal glue infusion 30min （T2）,60min （T3）,after operation 30min （T4）.Results When compared with that at T0,the CVP at T3 was significantly higher （P0.05）.APTT,PT began to increase at T1 （P0.05）,reached a peak （P0.05） at T2,returned to normal at T3.After the infusion of hypertonic crystal glue,the concentration of K＋ decreased,and the concentration Na＋ increased significantly at T1（P0.05）,and they basically restore to basic values concentration;Hct,Hb decreased with the infusion of fluid increased gradually （P0.05）;blood glucose at each time point had no significant difference.Conclusion The proper infusion of hypertonic crystal glue （5 ml/kg） for patients undergoing neurosurgery does not affect coagulation function and electrolyte,blood glucose.
出处
《海南医学》
CAS
2010年第10期21-22,25,共3页
Hainan Medical Journal
关键词
高渗氯化钠羟乙基淀粉40注射液
血液凝固
电解质
血糖
Hypertonic saline hydroxyethyl starch 40 injection
Blood coagulation
Electrolyte
Blood glucose
