乌司他丁与氨溴索合用对婴幼儿体外循环术后的肺保护作用

目的]探讨低体重婴幼儿体外循环（CPB）手术围术期联合应用乌司他丁与氨溴索的肺保护效果。方法]以60例体重7奴及以下的先天性心脏病室间隔缺损患儿为研究对象，随机分四组（每组15例）：氨溴索组（A组，氨溴索20mg／kg·d）、乌司他丁组（U组，乌司他丁1～2万U／d），联合组（AU组）按A、U组方案联合应用氨溴索和乌司他丁，对照组（C组）为空白对照，仅予以常规处理。以动态肺顺应性（Cd）、静态肺顺应性（Cs）以及呼吸指数（RI）来评价术后早期肺功能改变。结果]手术后1h，AU组Cd优于A组、C组，RI优于A组、U组；手术后24h，AU组Cd和RI优于其他组，Cs优于A组、U组。结论]围术期联合应用乌司他丁和氨溴索可抑制婴幼儿CPB术后炎症反应，改善术后肺功能，其效能大于其中任一药物单用。

Protective Effect of Ulinastatin and Ambroxol on Lung in Infants Undergoing Cardiac Operation under Cardiopulmonary Bypass

Objective] To study the lung protective effects of combined perioperative administration of ulinastatin and ambroxol in infants who underwent cardiac operation under cardiopulmonary bypass （CPB）. Methods] Sixty infants （weight less than 7 kilograms） with ventricular septal defect were divided randomly into four groups. The control group （Group C） was treated commonly, and the Group A was injected with ambroxol perioperatively, and the Group U was treated with ulinastatin and the Group AU was administrated with ulinastatin and ambroxol. The thoracic lung compliance （Cs）, dynamic lung compliance （Cd） and respira- tory index （RI） were measured at the beginning of CPB （T1）, 1 hour （T2） and 24 hour （T3） after the CPB. Results] At T2, Group AU had a higher Cd value than that of Group A and C, and a lower RI value than that of Group A and U. At T3, the Group AU had a higher Cd value and a lower RI value than those of other groups, and a higher Cs value than that of Group A and U. Conclusion]The perioperatively combined administration of ulinastatin and ambroxol has synergistic effect on lung protection, and can palliate the lung injury caused by CPB and improve the lung function.