【摘要】 目的　由于血液流变学特性是影响血液循环的重要因素 ,而妊娠期存在明显的血液流变学改变 ,因此该文研究中分子羟乙基淀粉 (贺斯 )对剖腹产患者术中血液流变学影响。方法　选择ASAⅠ～Ⅱ级剖腹产手术患者 4 0例 ,行连续硬膜外麻醉。开放前臂静脉 ,以 10ml/ (kg·h)的速度持续输液 ,输平衡液 5 0 0ml后开始硬膜外腔注局麻药 ,并根据继续补液性质的不同将患者随机分成两组 ,即平衡液组 (B组 ,n =2 0 )和贺斯组 (H组 ,n =2 0 )。监测记录HR、MAP、SpO2 的变化情况 ,记录手术结束时的失血量、尿量。并于输注治疗药前和输注治疗药后 (手术结束时 )采输注治疗药对侧前臂肘静脉血样 5ml,EDTA抗凝 ,送检血液流变学指标。结果　全血低、中切粘度 ,H组与B组比较降低明显 ;而血浆粘度B组有明显降低 ,但H组无明显变化。无论是H组还是B组全血还原低切粘度均有明显降低 ,但H组比B组更明显 ,两组间比较差异显著 ;全血还原中切粘度、血沉方程K值变化在B组不明显 ,H组则明显降低 ;红细胞聚集指数两组均见明显降低 ,但H组比B组降低更明显 ,两组间比较差异非常显著 ;纤维蛋白原数量无论是B组还是H组均有非常明显减少。结论　贺斯改善剖腹产患者术中血液流变学功能方面优于晶体液 -平衡液。剖腹产手术患者适当应用胶体液 -贺更多还原

【Abstract】 Objective:To investigate influence of medium molecular weight hydroxyethyl starch on hemorheology in patients with Cesarean section. Methods:Forty patients , ASA grade I-II, scheduled for Cesarean section by epidural anaesthesia were divided randomly into two groups : group B (n=20) received the balanced salt solution (BS) and group H (n=20) received HS for liquid therapy. Blood was taken from upper arm vein for determination of hemorheology outcome at the beginning and the end of BS or HS administration. Results:Compared with the group B , the viscosity of blood in group H under the condition of low shear rate (cp:10 s -1) and middle shear rate (cp:60 s -1) decreased significantly; the viscosity of plasma of group B decreased obviously , but it didn’t change significantly in the group H.Viscosities of blood of both groups under the condition of low shear rate decreased significantly, but viscosity of blood of group H decreased more significantly and the difference between two groups was significant. The viscosity of blood of group H under the condition of middle shear rate and ESR-K value of group H decreased significantly , but they didn’t change significantly in group B. The erythrocyte aggregation index of both groups decreased significantly, but it decreased more significantly in group H and the difference between two groups was significant. Meanwhile the concentration of fibrinogen of both groups decreased significantly,but it concentration of fibrinogen of both groups decreased signiticantly.Conclusions:Compared with BS,effect of HS is better on improving he morheology in patients with Cesarean section.更多还原