Hedstrand U, Högman C, Zarén B, Lundkvist B
Department of Anaesthesiology, University Hospital, Uppsala, Sweden.
Acta Chir Scand. 1987 Sep;153(9):501-5.
A prospective, controlled and randomized study of 275 patients undergoing major surgery was performed to investigate if postoperative complications were influenced by restrictive use of plasma to replace operative blood loss. All patients were given 6% dextran (Macrodex) for thromboprophylaxis and haemodilution. The "Dextran Group" received equal amounts of 6% dextran and electrolyte solution as substitution for plasma loss. The need for red-cell transfusion (60% suspension in saline-adenine-glucose-mannitol storage medium) averaged 5.8 units in this group and 5.2 in the "Plasma Group". The respective mean totals of infused plasma and dextran were 400 ml and 1,383 ml in the Dextran Group, compared with 1,099 and 619 ml in the Plasma Group. The mean total electrolyte infusion in the first postoperative week was c. 7,500 ml in both groups. Serum albumin decreased considerably in both groups, but significantly more in the Dextran Group. The incidence and pattern of postoperative complications were similar in both groups. When blood loss is up to 50-60% of the total volume, Macrodex can be used in preference to plasma, unless administration of plasma protein is specifically indicated.
对275例接受大手术的患者进行了一项前瞻性、对照和随机研究，以调查限制使用血浆替代术中失血是否会影响术后并发症。所有患者均给予6%右旋糖酐（Macrodex）进行血栓预防和血液稀释。“右旋糖酐组”接受等量的6%右旋糖酐和电解质溶液以替代血浆丢失。该组红细胞输注（在生理盐水 - 腺嘌呤 - 葡萄糖 - 甘露醇储存介质中的60%悬浮液）平均为5.8单位，“血浆组”为5.2单位。右旋糖酐组输注血浆和右旋糖酐的各自平均总量分别为400毫升和1383毫升，而血浆组为1099毫升和619毫升。两组术后第一周电解质输注总量平均约为7500毫升。两组血清白蛋白均显著下降，但右旋糖酐组下降更为明显。两组术后并发症的发生率和类型相似。当失血量达到总量的50 - 60%时，除非特别需要补充血浆蛋白，否则可优先使用Macrodex替代血浆。
