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发布者:鑫达医学翻译公司 发布时间:2011-11-08 8:50:52 阅读:

原文:
Background and Goal of Study: Despite a lack of evidence of its superiority over synthetic colloids, human albumin is still widely used in paediatric cardiac
surgery. This prospective randomised study compared 6% HES 13010.4 (Voluven®j to 4% human albumin in terms of calculated blood loss and fluid requirements in cyanotic children undergoing elective cardiac surgery.
Materials and Methods: After approval by the Ethic committee and parental informed consent, 44 cyanotic children (1-132 months) were randomised to receive up to 50 mllkg either HES 13010.4 (HES)or 4% albumin (Alb) for peroperative volume replacement including priming for the cardiopulmonary bypass circuit. Lactate ringer's was used for further per-operative volume needs. In the postoperative period (up to 24 h), albumin was the only colloid used to reach routine haemodynamic goals. Per and post-operative blood losses were measured but also calculated from estimated blood volume, pre and postoperative haematocrit and volume of red blood cell transfused. Efficacy was evaiuated by the amount of fluid infused at the end of the surgery and after 24 h. Data (mean ± SD) were compared between the two groups with unpaired Student t-test, Significance was accepted at p < 0.05.
Results and Discussions: Demographic data were similar in both groups.

译文:
目的:比较6%羟乙基淀粉130/0.4与4%人白蛋白对心外科手术患者失血与液体需求的影响。
实验设计:44位患者随机接受50ml/kg的羟乙基淀粉130/0.4或4%人白蛋白进行手术期间容量置换。比较不同处理组患者的失血量与液体需求量差异。
实验方法:44位患者随机接受50ml/kg的羟乙基淀粉130/0.4或4%人白蛋白进行手术期间容量置换。乳酸林格试剂用于进一步的容量需求。手术后24小时,白蛋白作为唯一的胶体用于维持常规血液动力学标准。检测手术期间及手术后失血量,并通过预期血容量,手术期间、手术后红细胞压积以及输入的红细胞体积进行测定。两种试剂的容量置换效率通过手术后24小时注射的液量进行评定。采用t-检验对两组实验数据进行比较。
实验结果:两组的统计数据基本相似。手术期间白蛋白处理组胶体注射量为49±5ml/kg,羟乙基淀粉处理组胶体注射量为47±8ml/kg,两处理组手术后胶体注射量分别为19±15ml/kg、24±22ml/kg。白蛋白处理组与羟乙基淀粉处理组患者手术期间注射类晶体的量分别为89±53ml/kg、59±40ml/kg。两处理组手术期间的失血量分别为21±13ml/kg、21±12ml/kg,手术后的失血量分别为45±38ml/kg、41±30ml/kg。两处理组患者总失血量分别为30±22ml/kg、24±16ml/kg。
结论:在本实验中采用6%羟乙基淀粉130/0.4进行容量置换与4%白蛋白相比在失血量方面效果相当。采用6%羟乙基淀粉130/0.4进行容量置换对手术期间类晶体的需求量有所降低。


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