摘要
目的 观察输注明胶溶液和右旋糖酐后对血小板膜糖蛋白Ⅱb/Ⅲa(GPⅡb /Ⅲa )和纤维蛋白原 (Fbg)的影响以及相互关系。方法 在硬膜外阻滞下行胆囊切除术的病人 10 5例 ,随机分为四组 ,术中分别输注生理盐水 30ml/kg、右旋糖酐 70 30ml/kg、尿联明胶 30ml/kg及改良明胶 30ml/kg。于输注前、输注后 2h及 3h采集静脉血 ,分别测定GPⅡb/Ⅲa和Fbg及血小板最大凝集率(MAR)。结果 四组Fbg在输注 2h和 3h后明显低于输注前 (P <0 0 5 )。右旋糖酐组输注液体 3h后GPⅡb/Ⅲa与输注前比较有显著降低 (P <0 0 1) ,与其它三组比较也显著降低 (P <0 0 1) ,生理盐水组输注液体 3h后MAR显著升高 (P <0 0 1) ,右旋糖酐组也显著的降低 (P <0 0 1)。结论改良明胶和尿联明胶在临床上可能比右旋糖酐使用更大的量而不造成出血倾向 ,胶体液较晶体液在术中更能稳定血小板 ,有助于止血功能的稳定。
Objective To investigate the effects of gelatins and dextran on fibrinogen and platelet glycoproteinⅡb/Ⅲa (GPⅡb/Ⅲa).Methods One hundred and five patients for selective cholecystectomy were randomly divided into four groups. In groupⅠ normal saline 30ml/kg was infused, in groupⅡ dextran-70 30ml/kg,in groupⅢ urea-linked gelatin 30ml/kg and group Ⅳ modified fluid gelatin 30ml/kg. The blood samples were taken before infusion ,two hours and three hours after the infusion, to measure platelet maximum aggregation rate (MAR), levels of Fbg and GPⅡb/Ⅲa,respectively.Results As compared with those in other groups, MAR and level of GPⅡb/Ⅲa decreased significantly in groupⅡ(P<0 05),which decreased markedly three hours after infusion in comparison with those before infusion (P<001). The levels of Fbg decreased significantly 2 and 3 hours after the infusion compared with those before infusion in four groups (P<001). MAR were increased significantly in groupⅠ(P<001) and decreased obviously in groupⅡ(P<001).Conclusions Infusing large dose of dextren inhibites the platelet function, but gelatin can help maintain the function of platelet.
出处
《中华麻醉学杂志》
CSCD
北大核心
2000年第3期142-144,共3页
Chinese Journal of Anesthesiology
关键词
右旋糖酐
明胶溶液
血小板膜糖蛋白
纤维蛋白原
Gelatin
Dextran
Platelet aggregation
Platelet membrane glycoprotein GPⅡb/Ⅲa complex
Fibrinogen
