乌司他丁和抑肽酶对心血管手术患者血液的保护作用

目的观察乌司他丁和抑肽酶对体外循环(CPB)心脏手术的血液保护功能。方法选择90例风湿性心脏病瓣膜置换术的患者,随机分成3组。乌司他丁组(30例):给予乌司他丁12000U/kg,于麻醉诱导后至CPB开始前缓慢静注半量,另半量加入预充液中随转机进入体内;抑肽酶组(30例):于CPB中一次性给予抑肽酶5000000U;对照组(30例):给予等量生理盐水。结果与对照组相比,乌司他丁组术后24h胸腔积液量减少33.3%(P<0.05),抑肽酶组术后24h胸腔积液量减少39.8%(P<0.05),乌司他丁组和抑肽酶组相比差异无统计学意义。抑肽酶组有2例发生严重过敏。结论乌司他丁和抑肽酶均具有维持纤溶活性稳定,保护血小板功能,从而减少术中及术后出血量。

Ulinastatin and Aprotinin to Blood Protection of Operation on Vessels of Heart

Objective To observe the ulinastatin and aprotinin to blood protection of extracorporeal circulation heart operation.Methods To select 90 cases of rheumatic heart disease undergoing valve replacement,90 patients were divided into three groups.The ulinastatin group(n=30):supply ulinastatin 12 000 IU/kg,after anesthesia induction to the begin of CPB,slow intravenous injection with half dose,the other half added to the priming solution and transfered into the body; the aprotinin group(n=30):In the CPB,supply the 5 million units aprotinin of one-time; the control group(30 cases):supply normal saline.Results Compared with the control group,there were significant decrease in 24-hours chest tube drainage in ulinastatin group(33.3% reduction),and 39.8% reduction in 24-hours chest tube drainage in aprotinin group(P<0.05).Ulinastatin group and aprotinin group had no significant difference.Aprotinin group had two cases of severe allergy.Conclusion Ulinastatin and aprotinin had effect in stabilizing fibrinolytic system,preserving platelet function during,leading to less postoperative blood loss.