The Effect And Security Of Preoperative Infusion With Hydroxyethyl Starch 130/0.4 Solution In Patients With Traumatic Brain Injury Undergoing Operation.

[Objective]:To study the effect and security of preoperative infusion with 6% hydroxyethyl starch 130/0.4 solution in patients with traumatic brain injury undergoing operation.[Methods]:40 patients with traumatic brain injury required surgery,were randomly divided into 2 groups of compound sodium lactate (LR) group(n=20) which 20ml/kg LR was injected before the anesthesia and 6% hydroxyethyl starch (HES) group which 10ml/kg HES was injected.Respectively,hemodynamic variables and the arterial blood gas analysis and blood electrolytes were detected in 5 point before treatment (T0),10 min (T1),20 min (T2)after pre-expansion and 1 min (T3),10 min (T4) after the skull plate cut.By enzyme linked immunoad sordent assay(ELISA),serum tumor necrosis factor-a(TNF-a) and interleukin-6 (IL-6) levels were analyzed immediately before and after surgery through the femoral vein blood.Blood sample was drawn for the measurements of blood prothrombin time (PT),activated part of the Prothrombin time(APTT),Fibrinogen(FIB),D-dimer,coagulation factorâ…§(Fâ…§:C)and blood platelets.[Results]:1. The MAP, HR,CVP of the HES group in 1 min,10 min after the skull plate cut was more stable than that of the control group(P<0.05); The amount of mannitol and norepinephrine which adminitrated in HES group was less than that in the LR group(P<0.05).2. The serum levels of TNF-a, interleukin-6(IL-6) in all patients with traumatic brain injury were significantly higher than that of healthy people(P<0.05); Compared with compound sodium lactate (LR) group,The serum levels of TNF-a, interleukin-6(IL-6) were significantly less in the HES group than that in the LR group after surgery. (P<0.05)3. The value offibrinogen (FIB) was less than that of before treatment when the end of surgery in both groups (P< 0.05) accompanied by D-dimer (D-dimer, DD) increased.[Conclusion]:1. Compared with 20ml/kg lactated Ringer's solution(LR), rapid plasma volume expansion with 10ml/kg Hydroxyethyl Starch 130/0.4 Solution before anesthesia could maintain better blood hemodynamics in patients with acute traumatic brain injury.2. Hydroxyethyl Starch 130/0.4 Solution can inhibit releasing of inflammatory cytokines and decrease the serum levels of TNF-a,IL-6 in patients with traumatic brain injury.