脳神経外科領域におけるHydroxyethyl-Starch （HES）の使用経験

CLINICAL STUDY OF HYDROXY ETHYL STARCH (HES) ON NEUROSURGICAL DISEASE

Ｉ．はじめに

　dextranをはじめ，これまで使用されてきた血漿増量剤は，本来の血漿増量作用のほかに，抗原性，出血傾向および腎機能に対する障害があり，さらに貯蔵の問題などで不利な点があげられていた。

　1957年Wiedershein^12）により開発されたhydroxye—thyl Starch （以下HESと略す）は，1962年のTho—mpson^11）らの基礎研究，Ballinger^1）らの臨床研究によつてすぐれた血漿代用液であることが認められ，臨床使用への段階へと進みつつある。

The effect of the administration of hydroxy-ethyl starch (HES) was studied and evaluated on 20 patient, having mainly cerebral vascular di-sorders. in all cases 500 ml of HES was infused per day intravenously.

The results were following :

1) Mean arterial pressure after administration of HES was well maintained and also the dys-function of liver, kidney and coagulation fortors were not recognized.

2) Hematocrit value, hemoglobin rate and serum electrolytes after use of HES were not so signicant.

3) HES served to be a plasma expander ade-quately with the nonimmunogenicity, preservativity and physical stability.

4) Some cases were demonstrated a hemorrhagic tendency following the over 7 day's administration of HES continuously, therefore the long-term use of HES gave a warning.

5) The most striking side effects following the infusion of over 7 day's HES were the moderate prolongation of bleeding time, increase of anti-fibrinolytic activity and decrease of platelets. The mechanism of these hemorrhagic factors was dis-cussed.

6) To conclude this very brief summary of our investigation, we can say that HES seems to be a valuable plasma expander or a effective hemodilute fluid for peripheral circulatory disturbence as dextran 70 and dextran 40.