乌司他丁在门静脉高压症断流术后应用的临床观察

目的探讨乌司他丁在门脉高压症断流术后的治疗价值。方法分析我科2009年1月至2011年12月期间收治的45例肝硬化门脉高压症患者，均行贲门周围血管离断加脾切除术。根据术后用药分为两组，A组为糖皮质激素组（n=23），B组为乌司他丁组（n=22）。比较两组患者术后1、4、7d肝功能、出凝血功能、SIRS评分以及术后相关并发症发生率。结果乌司他丁组围手术期全身炎症反应及肝功能指标恢复与激素组相似，无统计学差异。乌司他丁组在门静脉系统血栓形成、感染等并发症的发生率低于激素组。结论门脉高压症患者断流术后应用乌司他丁和糖皮质激素治疗，均可减轻术后炎症反应，促进肝功能恢复，但应用乌司他丁较糖皮质激素并发症少，有更高的安全性。

Clinical observation of ulinastatin on post-devascularization in patients with portal hypertens-

To explore the clinical results of ulinastatin in treatment of post-devascularization in portal hypertensive patient. Methods Forty-five patients who underwent devascularization from 2009 to 2011 were divided into glucocorticoid group （A group, n=23） and ulinastatin group （B group, n=22）. Postopera- tive hepatic function, blood coagulation function, SIRS scores and the morbidity of complications were retro- spectively compared with each other. Results Postoperative SIRS scores and hepatic function were similar in the two groups, however the morbidity of complications such as infection and portal vein thrombosis in ulinastatin group were lower than that in glucocorticoid group. Conclusion The post-devascularization pa- tients are treated by ulinastatin during the perioperation, it is effective in reducing SIRS scores and promoting the recovery of hepatic function as glucocorticoid. In addition, it is more safe than glucocorticoid in reducing the morbidity of complications.