目的 研究羟乙基淀粉和琥珀酰明胶用于心肺转流(CPB)预充时对患者凝血功能及胶体渗透压的影响.方法 60例先天性非紫绀心脏病患者,随机均分为两组:羟乙基淀粉组以6％羟乙基淀粉130/0.4预充,琥珀酰明胶组以4％琥珀酰明胶预充.手术室及ICU根据分组情况亦分别输注羟乙基淀粉和琥珀酰明胶.于CPB前、给鱼精蛋白后、ICU 6 h测定激活凝血时间(ACT)、凝血速率(CR)及血小板功能(PF)；于CPB前、CPB中、CPB后、ICU2 h和6h测定胶体渗透压.结果 给鱼精蛋白后和ICU 6 h,羟乙基淀粉组PF明显高于琥珀酰明胶组(P＜0.05),其余指标差异无统计学意义.结论 6％羟乙基淀粉130/0.4与4％琥珀酰明胶作为胶体预充液在心肺转流中使用安全性相似.%Objective To compare the effects of two different artificial colloids on coagulation function and colloid osmotic pressure in cardiopulmonary bypass (CPB). Methods Sixty adult patients with acyanotic congenital heart disease were equally randomized into two groups, hydroxyethyl starch group using 6% hydroxyethyl starch 130/0. 4 as priming fluid and succinylated gelatin group using 4% succinylated gelatin as priming fluid. Hydroxyethyl starch and succinylated gelatin was infused during perioperative 24 hours. Activated clotting time (ACT) , clot rate (CR) and platelet function (PF) were measured pre-CPB, after protamine administration and 6 hours after ]CU admission. Colloid osmotic pressure was evaluated pre-CPB, during CPB, after weaning from CPB, and 2 hours and 6 hours after ICU admission. Results PF in hydroxyethyl starch group was higher than that in succinylated gelatin group after protamine administration and 6 hours after ICU admission (P<0.05). There was no significant difference between the two groups regarding the other parameters. Conclusion Six percent hydroxyethyl starch 130/0.4 and 4% succinylated gelatin as priming fluid have similar effects on coagulation function and colloid osmotic pressure in CPB except for PF.
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