乌司他丁对肢体缺血再灌注性肺通气和氧合功能的影响

目的：观察乌司他丁对肢体缺血再灌注性肺通气和氧合功能的影响,为临床应用提供实验依据。方法：选择应用止血带的下肢手术患者30例,随机分为对照组和治疗组。对照组在上止血带前10 min静脉滴注生理盐水100 mL;治疗组则在相同时间内静滴乌司他丁溶液（0.6×104 U/kg）100 mL。分别于上止血带前0 h、松止血带后2 h、6 h、24 h取血测血气记录动脉血二氧化碳分压（PaCO2）,计算肺泡动脉血氧分压差（PA-aO2）和氧合指数（OI）值。结果：对照组在2 h,6 h,24 h时点PA-aO2差值较0 h时点的明显增大（P〈0.01）,治疗组各时点组内的变化差异无显著性,治疗组6 h时点的差值增大幅度较对照组小（P〈0.05）。OI值各组变化与PA-aO2相反。而两组PaCO2值在2 h都有升高（P〈0.01）,在6 h,24 h时点恢复,且两组间差异无显著性。结论：乌司他丁预处理能改善肢体缺血再灌注损伤后的肺泡的通气功能和氧合功能,对缺血后再灌注损伤组织有保护作用。

Effect of Ulinastatin on the parameters of pulmonary ventilation and oxygenation induced by reperfusion injury after ischemia of lower extremity

Objective：To obsenve the effect of Ulinastatin on the parameters of pulmonary ventilatory function and oxygenation induced by reperfusion injury after ischemia of lower extremity.Methods：Thirty cases of lower limb operation were randomly assigned to two groups：Control group（n =15）was administered saline 100 ml intravenously at 10 minutes before appli-cation of tourniquet.Treatment group（n =15） was undergone the treatment of Ulinastatin（0.6 ×104 U/kg） solution 100 ml replace the saline intravenously at the same time and the same application of tourniquet compared with control group.Peripheral arterial blood was sampled at the time of prior to the application of tourniquet（0 hour）,and at 2 hours（2 h）,6 hours（6 h）,and 24 hours（24 h） after releasing tourniquet,for the measurement of arterial blood gas analysis and the calculation of the alveolar-arterial PO2 difference（PA-aO2） and oxygen index（OI） and the partial pressure of carbon dioxide in artery（PaCO2） were made.Results：The parameters of PA-aO2 was significantly elevated at 2 hours,6 hours and 24 hour after releasing tourniquet compared with that in 0 hour before application of tourniquet in control group（P 0.01）,the same variation was not appeared in the treatment group with Ulinastatin.It was showing lower PA-aO2 in the treatment group than that in the control group at 6 hours.The change of OI was opposite to PA-aO2,and the PaCO2 was significantly elevated at 2 h in both groups.Conclusion：Ulinastatin treatment can improve the disfunction of pulmonary ventilation and oxygenation induced by reperfusion injury after ischemia of Lower Extremity and show protective effect against the reperfusion injury after ischemia.