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右旋糖酐和晶体液对皮下氧张力及胶原积聚的影响。一项针对外科手术患者的随机研究。

Effects of dextran and crystalloids on subcutaneous oxygen tension and collagen accumulation. A randomized study in surgical patients.

作者信息

Hartmann M, Jönsson K, Zederfeldt B

机构信息

Department of Anaesthesiology, Malmö General Hospital, University of Lund, Sweden.

出版信息

Eur Surg Res. 1993;25(5):270-7. doi: 10.1159/000129289.

Abstract

Twenty-nine patients, subjected to major abdominal surgery, were randomized to different types of postoperative fluid replacement, given on the basis of subcutaneous oxygen tension measurements (PscO2). One regimen consisted of crystalloids, the other of a combination of crystalloids and colloids (dextran 70). Perioperative fluid replacement was given according to clinical criteria and postoperatively according to polarographic PscO2 measurements. PscO2 was measured by a silicone catheter implanted in the upper arm. Two tubes of expanded polytetrafluoroethylene (ePTFE) were implanted next to the silicon catheter. They were removed on day 5 and 7, and analysed for hydroxyproline content. Total postoperative fluid support was equal in the two groups, and so was the hydroxyproline content on day 7. In conclusion, postoperative fluid substitution with dextran has no advantages over crystalloids only, with regard to granulation tissue formation if postoperative fluid support is optimum, according to PscO2 measurements.

摘要

29例接受腹部大手术的患者被随机分为不同类型的术后液体补充组,补液方案根据皮下氧分压(PscO2)测量结果制定。一种方案是晶体液,另一种是晶体液和胶体液(右旋糖酐70)的组合。围手术期补液根据临床标准进行,术后根据极谱法测量的PscO2进行。PscO2通过植入上臂的硅胶导管测量。在硅胶导管旁植入两根膨体聚四氟乙烯(ePTFE)管。分别在第5天和第7天取出,并分析羟脯氨酸含量。两组术后总的液体支持量相等,第7天的羟脯氨酸含量也相等。总之,根据PscO2测量结果,如果术后液体支持量最佳,在肉芽组织形成方面,用右旋糖酐进行术后液体替代并不比单纯使用晶体液有优势。

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