中华医学杂志（英文版）2003，Vol.116Issue(7)：996-1000,5.
Effect of volume replacement with hydroxyethyl starch solution on splanchnic oxygenation in patients undergoing cytoreductive surgery for ovarian cancer
Effect of volume replacement with hydroxyethyl starch solution on splanchnic oxygenation in patients undergoing cytoreductive surgery for ovarian cancer
郭向阳 1徐仲煌 1任洪智 1罗爱伦 1黄宇光 1叶铁虎1
作者信息
- 1. Department of Anesthesia,Peking Union Medical College Hospital, Beijing 100730, China
- 折叠
摘要
Abstract
Objective To investigate the effectiveness of using a medium molecular weight hydroxyethyl starch solution (HES) administered as a replacement for estimated blood loss (EBL) during cytoreductive surgery for ovarian cancer on splanchnic oxygenation. Methods Forty-two patients undergoing cytoreductive surgery for ovarian cancer were enrolled in this prospective randomized study. As soon as the EBL exceeded 10% but was less than 20% of the estimated blood volume, the patients were randomly assigned to receive either a volume of lactated Ringer's solution (LRS) equal to three times the EBL (LRS group, n=22) or a volume of 6% HES equal to the EBL (HES group, n=20). Tissue oxygenation was assessed indirectly by measuring tonometric parameters, including the difference between gastric intramucosal PsCO2 and arterial PaCO2 (Ps-a CO2 gap), gastric intramucosal pH (pHi) and arterial lactate acid concentration at 30 min after induction of anesthesia (baseline value), 1 hour and 2 hours after skin incision, and at the end of surgery. Results At the end of surgery,the Ps-a CO2 gap in the HES group (8.7±1.6 mmHg) was significantly lower than that of the LRS group (18.74±4.4 mmHg, P<0.01), while the pHi (7.30±0.05 mmHg) in the HES group was significantly higher than that of the LRS group (7.21±0.07 mmHg, P<0.01). There was no significant difference between the two groups in terms of arterial lactate acid concentration. Conclusion In patients undergoing major surgery with relatively large blood losses, volume resuscitation with medium molecular weight hydroxyethyl starch solution may improve splanchnic blood flow and tissue oxygenation.关键词
hydroxyethyl starch/cytoreductive surgery/gastric mucosa/splanchnic oxygenationKey words
hydroxyethyl starch/cytoreductive surgery/gastric mucosa/splanchnic oxygenation分类
医药卫生引用本文复制引用
郭向阳,徐仲煌,任洪智,罗爱伦,黄宇光,叶铁虎..Effect of volume replacement with hydroxyethyl starch solution on splanchnic oxygenation in patients undergoing cytoreductive surgery for ovarian cancer[J].中华医学杂志（英文版）,2003,116(7):996-1000,5.
