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目的 :观察急性中度等容血液稀释和输入 6 %中分子羟乙基淀粉 (2 0 0 0 5 ,HES)对肝癌切除术患者凝血功能的影响。方法 :ASAⅡ级行肝癌切除术患者 31例 ,年龄 (48± 9)岁。全麻后采血并输入 6 % ,HES行中度等容血液稀释 (ANH)。测定术前、采血 (血液稀释 )后、术中和回输自身血后的血小板计数 (PLT)、凝血酶原时间 (PT)、纤维蛋白原 (FIB)、部分凝血活酶时间(APTT)和凝血酶时间 (TT)的改变。结果 :采血后和术中PLC、FIB显著下降 (P <0 0 1) ,PT、APTT显著延长 (P <0 0 1) ,但仍在生理范围内。回输自身血后上述指标明显恢复 (P <0 0 5或 <0 0 1)。手术野和切口无异常出血。结论 :急性中度血液稀释和输入较大量 6 %HES对PLT和部分凝血因子有一定干扰作用 ,但仍在生理范围 ,对凝血功能无明显影响 ,可安全应用
Objective: To observe the effect of acute moderate isodose hemodilution and infusion of 6% HES on the coagulation function in patients undergoing hepatectomy. Methods: Thirty-one patients with ASA grade II hepatectomy (mean age 48 ± 9 years) were enrolled. After general anesthesia, blood was collected and input 6%. HES was given moderate isovolemic hemodilution (ANH). The PLT, PT, fibrinogen (FIB), partial thromboplastin time (APTT), and serum creatinine Thrombin time (TT) changes. Results: The levels of PLC and FIB were significantly decreased (P <0.01) and PT and APTT were significantly prolonged (P <0.01) after blood collection and intraoperative, but still within the physiological range. After the return of own blood, the above indexes recovered obviously (P <0 05 or <0 0 1). Surgery and incision no abnormal bleeding. CONCLUSIONS: Acute moderate hemodilution and the introduction of larger amounts of 6% HES have some interference with PLT and some coagulation factors, but are still in physiological range with no significant effect on coagulation and can safely be used