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高渗氯化钠羟乙基淀粉40注射液预扩容对母婴血浆胶体渗透压的影响
The effects of hypertonic sodium chloride hydroxyethyl starch 40 injection preload on plasma colloid osmotic pressure in the parturient undergoing cesarean section

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DOI:
作者:
朱慧琛，忻纪华，何征宇，王祥瑞
Zhu Huichen,Xin Jihua,He Zhengyu,Wang Xiangrui
作者单位:
上海交通大学医学院附属仁济医院麻醉科
Department of Anesthesiology, Renji Hospital, Shanghai Jiaotong University School of Medicine
关键词:
高渗氯化钠羟乙基淀粉40注射液；血浆胶体渗透压；剖宫产；腰硬联合麻醉
hypertonic sodium chloride hydroxyethyl starch 40 injection; plasma colloid osmotic pressure; cesarean section; spinal-epidural anesthesia
摘要:
目的 观察高渗氯化钠羟乙基淀粉40注射液（HSH40）预扩容对母婴血浆胶体渗透压的影响。方法 选择择期行剖宫产产妇80例，随机分为2组，每组40例。H组预输注高渗氯化钠羟乙基淀粉40注射液4ml/kg；L组预输注复方乳酸林格氏液4ml/kg。监测并记录入室时(T0)、预充量输注完即刻(T1)、输注后30min(T2)、胎儿娩出时(T3)、术毕(T4)的HR、BP，并采集各时间点的血样和脐动、静脉血检测血浆胶体渗透压。结果 各时间点血浆胶体渗透压H组明显高于L组（P<0.05）；胎儿脐血血浆胶体渗透压两组无明显差异（P>0.05）。结论 高渗氯化钠羟乙基淀粉40注射液预扩容有利于维持产妇术中血浆胶体渗透压和血流动力学的稳定，且对胎儿血浆胶体渗透压无影响。
Objective To observe the effects of hypertonic sodium chloride hydroxyethyl starch 40 injection(HSH40) preload on plasma colloid osmotic pressure in parturient undergoing cesarean section. Methods 80 patients undergoing elective cesarean section under spinal-epidural anesthesia were randomized into two groups of H(HSH40 4ml/kg), L(Ringer’s solution 4ml/kg). The blood samples were taken to measure the levels of plasma colloid osmotic pressure(COP) and hemodynamic parameters(HR、BP) before infusion(T0), at the end of infusion(T1) and 30 min after infusion, at delivery of baby(T3) and the end of operation(T4). Umbilical venous and arterial blood samples were also obtained immediately after delivery for determination of COP. Results The plasma colloid osmotic pressure of H group was significantly higher than the L group at each time point（P<0.05）; no differences in neonatal COP were seen with two groups（P>0.05）. Conclusion Preload of hypertonic sodium chloride hydroxyethyl starch 40 injection can maintain maternal COP, stable maternal hemodynamic. It do not affect fetal COP.

 

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