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BACKGROUND AND PURPOSE: allogeneic blood transfusion caused the harm has been encouraging people to continue to develop new techniques and methods to reduce allogeneic blood transfusion in surgery. Preoperative autologous blood, careful hemostasis in surgery, intraoperative and postoperative blood loss back to strictly control the input and intraoperative transfusion indications can be used to reduce allogeneic blood transfusion in surgery. In recent years, with the gradual deepening of the Mechanism of hemodilution, preoperative hemodilution (Hemodicution, HD) has become one of the clinical blood conservation used effectively. Acute hemodilution (Acute Normovolencic Hemodilution, ANH) and acute hypervolemic hemodilution (Acute Hyperyolemic Hemodilution, AHH), acute hypervolemic hemodilution nineties of the last century a new blood conservation methods, simple, low-cost, reduce blood contamination, has more advantages than the acute hemodilution, clinical applications gradually increased. 6% hydroxyethyl starch (Hydroxyethl Starch, HES) is a new generation of artificial colloid wide range of clinical applications. Effective expansion to maintain circulation stable for a long time, the infusion can significantly improve microcirculation perfusion and tissue oxygenation and a unique capillary leak sealing effect, and fewer adverse reactions, allergic reactions, hemodilution and capacity treatment of plasma substitutes. Imports the HES (Voluven) and domestic the HES (泽 Mu) in the domestic market, is widely used in the the capacity replacement therapy, and confirmed that they have good security. This study was 6% hydroxyethyl starch 130/0.4 (HES) acute hypervolemic hemodilution on hemodynamics and coagulation. Methods: 60 patients undergoing elective surgery patients, ASA Ⅰ Ⅱ grade, were randomly divided into domestic HES group (Ze Mu; HESa that Group A) and imports HES group (Voluven; HESb group B) and sodium lactate Ringer's solution group (ie C group) and 20 cases each. Burglary intubation physical requirements supplementary lactated Ringer injection 8ml/Kg, water fasting. After anesthesia induction the input HESa or HESb or lactated Ringer solution 20ml/Kg losers (25 ± 5) min, respectively, observed infusion balanced salt solution Bi (To), after infusion AHH (T < / sub>) AHH after 30min (T 2 ), AHH after 60min (T3) Bp, CVP, HR, Hb, HCT, prothrombin time (PT), thrombin time (TT ), activated partial thromboplastin time (APTT), fibrinogen (FIB) Results: 1, General Information: three groups of patients age, weight, foundation HCT value difference had no statistical significance (P lt; 0.05), three groups of patients AHH after the HCE are reduced to about 30%, to achieve the moderate hemodilution. AHH ago, AHH both A and B are two groups of patients, PT, APTT significantly longer the FIB the two groups were significantly decreased, there was no statistically significant difference between groups within the group. Group A and Group B FIB was significantly lower than that in group C (P lt; 0.05). The 4 hemodynamic changes: SBP, DB P, HR, CVP differences among the groups in T 1 point in time without significant resistance (P gt; 0.05) AB patients HR in T 1 ~ T 3 When compared To have elevated the SBP, DBp, T 1 When compared To was increased in T 2 , T 3 than To lower, but still within the normal range, the comparison between groups T 1 ~ T 3 each time point was no significant difference (P gt; 0.05). Group C in T , 3 SBP and DBP was significantly lower (P lt; 0.05) higher than that in group A and group B, HR T 3 . 5, Hb, HCT various indicators of change: three groups of patients with Hb, HCT, the T 3 and To decrease P lt; 0.05, group A and group B group comparison of Hb, HCE To, T 3 differences in point in time no significant P gt; 0.05. The HCT of group A and group B was significantly lower than in group C (P lt; 0.05). Conclusion: Preoperative AHH can expand blood volume, increase the body's tolerance to blood loss, effectively reducing allogeneic transfusion. 2, like domestic the HES and imported HES has a good role in the expansion, is ideal plasma substitutes. 3,6% hydroxyethyl starch 130/0.4 on Coagulation suppress certain extent, be careful with large doses.
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