Effects Of Different Doses Of Hydroxyethyl Starch (130/0.4) On Hemorheology And Blood Coagulation Function In Patients During Colorectal Cancer Surgery

Objective To investigate the effects of different doses of Hydroxyethyl starch onhemorheology and blood coagulation function in Patients during Colorectal Cancer Surgery.Methods Sixty patients undergoing colorectal cancer surgery were involed and randomlyassigned to3groups according to different doses of hydroxyethyl starch(130/0.4) theyreceived: group A (10ml· kg－1), group B (15ml· kg－1), group C (20ml· kg－1).(lowshear rate, shear rate and high shear rate) in the whole blood viscosity, plasma viscosity (ηp),red blood cells deposited (Hct), whole blood (high cut、low cut) reduction viscosity,erythrocyte rigidity index (ERI), erythrocyte aggregation index (EAI) and prothrombin time(PT), activated partial prothrombin time (APTT), fibrinogen (FIB), hemoglobin (HB), plateletcount (PLT) were monitored and recorded before the capacity,after the capacity30min(T1),3.5h (T2). Results (1) general information: three groups of patients age, sex,weight, ASA grade, operation time, intraoperative blood loss, no statistically significantdifference.Compared with group A, group C crystal input and urine volume difference wasstatistically significant (P＜0.05).(2) the vital signs: compared with group A: T0, group B andC mean arterial pressure, central venous pressure, heart rate, and pulse oxygen saturation werenot statistically significant;T1, group B were no statistical significance of each index, meanarterial pressure of group C was statistically significant (P＜0.05);T2, group C mean arterialpressure and pulse oxygen saturation was statistically significant (P＜0.05).Group Ccompared with group B: T0, the indicators are not significant;T1, T2, mean arterial pressureof group C were statistically significant (P＜0.05).When compared with T0, T1, T2, three groups of mean arterial pressure and pulse oxygen saturation were statistically significant (P＜0.05).When compared with T1, T2,Aset of pulse oxygen saturation was statisticallysignificant (P＜0.05).(3) Hemorheology indexes, compared with group A: T0, B and C group(low, medium and high shear rate of whole blood viscosity, plasma viscosity, erythrocytedeposited, whole blood (high and low cut) reduction viscosity, erythrocyte rigidity index anderythrocyte aggregation index were not statistically significant;T1, B group of low shear rateof whole blood viscosity, erythrocyte deposited and erythrocyte aggregation index wasstatistically significant (P＜0.05), group C in patients with low shear rate of whole bloodviscosity, high shear rate of whole blood viscosity, erythrocyte rigidity index and erythrocyteaggregation index was statistically significant (P＜0.05);T2, B group of red blood cellsdeposited was statistically significant (P＜0.05), group C in patients with low shear rate ofwhole blood viscosity, erythrocyte deposited and erythrocyte aggregation index, index wasstatistically significant (P＜0.05).Group C compared with group B: T0, each index is notsignificant;T1, T2, low shear rate of whole blood viscosity of group C were statisticallysignificant (P＜0.05).Compared with the T0, T1, A, B group of patients’ whole bloodviscosity, plasma viscosity, erythrocyte deposited and erythrocyte rigidity index, erythrocyteaggregation index were statistically significant (P＜0.05), group C whole blood viscosity,plasma viscosity, erythrocyte deposited, erythrocyte rigidity index, erythrocyte aggregationindex, whole blood high shear viscosity of whole blood reductive viscosity and reduction wasstatistically significant (P＜0.05);T2, group B in the shear rate of whole blood viscosity,plasma viscosity, erythrocyte deposited and erythrocyte rigidity index had statisticalsignificance (P＜0.05), group C whole blood viscosity, plasma viscosity, whole blood highshear reductive viscosity, whole blood low shear reduction viscosity, erythrocyte deposited,erythrocyte rigidity index, erythrocyte aggregation index was statistically significant (P＜0.05);When compared with the T1, T2, group A low shear rate of whole blood viscosity,erythrocyte pressure volume, erythrocyte aggregation index, index rise, with statistical significance (P＜0.05), group B low shear rate of whole blood viscosity and erythrocyteaggregation index, index increased, with statistical significance (P＜0.05).(4) coagulantfunction index: compared with group A: T0, group B, group C PT, APTT, fibrinogen,hemoglobin and platelet counts were not significant;T1, fibrin group C original statisticalsignificance (P＜0.05);The indicators T2, B and C group were not significant.Compared withgroup B, T0, T1, group C each index had no statistical significance.When compared with T0,T1, three groups of patients, PT, APTT, fibrinogen, hemoglobin, platelet count wasstatistically significant (P＜0.05), when the T2, A group of hemoglobin, platelet count wasstatistically significant (P＜0.05);Group B APTT, hemoglobin, platelet count was statisticallysignificant (P＜0.05);Group C PT, APTT, fibrinogen, hemoglobin, platelet count wasstatistically significant (P＜0.05).Three groups when compared with T1, T2PT, APTT, FIBand hemoglobin, platelet count indexes had no statistical difference.Three groups of patients,PT, APTT, FIB and hemoglobin, platelet count change are within the normal range.Conclusion For patients with colorectal cancer surgery, different doses of hydroxyethylstarch (130/0.4) input can make the patients’ whole blood viscosity, erythrocyte pressuredecrease, erythrocyte rigidity index and aggregation index decreased, hydroxyethyl starch(130/0.4) input dose increases, input after30min of hemorheology in patients with influenceobviously, there are still effects in patients with input after3.5h. Intraoperative input degreeof small doses of hydroxyethyl starch (130/0.4) changing the parameters of blood coagulationfunction, but all within normal range, three groups of doses of hydroxyethyl starch had noobvious effect on blood coagulation function.