The Comparative Study Of The Artificial Colloid And Plasma In Abdominal Surgery

Objective To investigate the difference of the efficiency between the hydroxyethyl starch and frozen plasma given in the patients undergoing abdominal operation,state the statistical proof for the index of plasma usage,regulate the application of the human blood product. Method Forty-four patients who underwent abdominal operation in the affiliated hospital of Qingdao university medical college from June ,2006 to March ,2007 were divided into two groups,the hydroxide starch group(HES) and frozen plasma group(FP).During the operation day to the sequent two days ,the HES group was given 500ml hydroxyethyl starch (130/0.4) each day while the FP group was given 300-500ml frozen plasma each day. The crystalloid was given as extra therapeutic volume. The mean arterial blood pressure(MAP),pulse ,central venous pressure(CVP),PH value of arterial blood(PH),partial pressure of carbon dioxide of arterial blood(PaCO₂),partial pressure of oxygen of arterial blood(PaO₂),hemoglobin(HB),the venous-arterial PaCO₂ difference(VAPCO₂) were measured at preoperative day,operation day ,the time soon after operation,postoperative 6 hours,postoperative 24 hours,postoperative 48 hours. The coagulation function,blood albumin concentration was measured at preoperative day, postoperative day one , postoperative day three. Record the urine volume, drainage volume, operation complications ,the amount of the albumin and red blood cell product ,days of hospitalization after operation. The results are analyzed with the SPSS statistical software of version 13. Result At the postoperative 6 hours, there are statistical differences between the HES group and FP group in CVP, MAP, VAPCO₂.The pulse of the two groups has no statistical differences at any recorded time . The there are statistical differences between the HES group and FP group in prothrombin time (PT) activated partial thromboplastin time(APTT) ,fibrinogen (Fbg) and thrombin time (TT) at postoperative day one. In the HES group ,there are statistical differences between preoperative day and postoperative day one in PT,APTT,Fbg,TT. In the FP group , there are no statistical differences between preoperative day , postoperative day one and two in PT,APTT,Fbg,TT. The platelet count (PLT) of the two groups has no statistical differences at any recorded time. The blood albumin concentration of the two groups has no statistical differences at any recorded time. The is no death case in the patients who participated in the trial . There are no statistical differences in the urine volume, drainage volume, operation complications ,the amount of the albumin and red blood cell product ,days of hospitalization after operation between two groups. Conclusion The artificial colloid of hydroxyethyl starch has better effects in persistence time of volume expansion, improving the perfusion of microcirculation to the tissue compared with blood plasma.The artificial colloid of hydroxyethyl starch can be used for recovery and rescue at the emergency and shock cases. Frozen plasma can reduce the impact of operation to the coagulation function while artificial colloid of hydroxyethyl starch has little influence on the coagulation function. Artificial colloid of hydroxyethyl starch can be applied to patients with normal coagulation function, but in the abnormal case with great carefulness. Artificial colloid of hydroxyethyl starch doesn't increase the complication rate of operation nor the morbidity of hypoproteinemia compared with blood plasma. It can be safely used in abdominal operation.