摘要
目的观察乌司他丁对直肠癌患者术中凝血功能的影响。方法拟行直肠癌根治性手术患者30例,肿瘤淋巴转移分期(TNM)Ⅱ或Ⅲ期,随机均分为乌司他丁组(U组)和生理盐水组(N组),分别在入室后10 min内泵注5 000 U/kg乌司他丁和生理盐水各20 ml。分别于给药前(T0)、给药后1 h(T1)、2 h(T2)抽取外周静脉血测定血小板活化标志物血小板膜糖蛋白(CD62P、CD63),凝血指标:凝血酶原时间(PT)、部分凝血酶原时间(APTT)、凝血酶时间(TT)、纤维蛋白原(FIB)及血小板相关指标:血小板计数(PLT)、血小板分布宽度(PDW)、平均血小板体积(MPV)、大血小板比率(P-LCR)并记录失血量。结果与T0时比较,U组CD62P、CD63在T1和T2时明显降低(P<0.05);PT在T1和T2时均明显延长(P<0.05),APTT在T1时显著延长(P<0.01),TT在T2时明显延长(P<0.05);N组APTT在T2时显著缩短,N组PDW、MPV、P-LCR在T1和T2时明显高于T0时(P<0.05)。与N组比较,U组CD62P、CD63、PDW、MPV、P-LCR在T1和T2时明显降低(P<0.05),PT在T1、T2时均延长,APTT在T1时显著延长,TT在T2时亦延长。结论乌司他丁可能对直肠癌患者的血液高凝状态有一定的改善作用。
Objective To investigate the effect of ulinastatin on blood coagulation in paients undergoing rectal cancer surgery. Methods Thirty patients （TNM Ⅱ or Ⅲ ）, scheduled for radical resection of rectal cancer （Dixon）, were randomly divided into two groups （n= 15）, ulinastatin group （group U） and normal saline group （group N）. The patients in the group U were given 5 000 units/ kg of ulinastatin, which were mixed in 20 ml normal saline and administered intravenously via injection pump in 10 mira group N received the same volume of normal saline. Platelet molibizing function（CD62P, CD63）, blood clotting function （PT, APTT, TT, FIB）and platelet-related parameters（PLT, PDW, MPV, P-LCR）were measured at 3 time points., pre-infusion （T0）, 1 hour after the infusion （T1）, and 2 hours after the infusion （T2）. Blood loss was recorded. Results Compared with To, activation markers of platelet CD62P and CD63 were obviously decreased at T1 and T2, APTT prolonged significantly at T1 （P 〈0. 01）, TT prolonged significantly at T2, PT prolonged significantly at T1 and T2 in group U, APTT were shortened at T2 in group N. In group U, CD62P, CD63, MPV, PDW, PLCR were significant lower than those in group N at T1 and T2 （P 〈0. 05）. PT in group U were longer than those in group N at T1 and T2. APTT was obviously longer than that in grorp N at T1, so was TT at T2. Conclusion Ulinastatin may improve the blood hypereoagulable state for patients undergoing rectal cancer surgery.
出处
《临床麻醉学杂志》
CAS
CSCD
北大核心
2011年第9期848-850,共3页
Journal of Clinical Anesthesiology
关键词
乌司他丁
血液高凝
血小板活化
凝血指标
Ulinastatin
Blood coagulation
Platelet activation
Coagulation parameters
