摘要
目的探讨乌司他丁(ulinastatin,UTI)对恶性肿瘤根治术患者凝血功能的影响。方法择期ASAⅠ或Ⅱ级腹部恶性肿瘤根治术患者60例,随机均分为三组。所有患者采用气管插管全麻,麻醉诱导后Ⅰ组静注UTI 5 kU/kg;Ⅱ组静注UTI 10 kU/kg,均加入生理盐水100 ml;Ⅲ组给予等容量生理盐水。于入室时(T_0)、切除肿瘤时(T_1)、术毕(T_2)、术后24 h(T_3)采静脉血检测血常规及凝血功能指标及D-D二聚体,并记录术中出血量、输血量及术后24 h引流量等。结果 T_1～T_3时三组血小板计数(Plt)均明显低于、纤维蛋白原(FIB)、D-D二聚体均明显高于T_0时(P<0.05),Ⅲ组Plt明显低于、FIB、D-D二聚体均明显高于Ⅰ、Ⅱ组,Ⅰ组Plt明显低于、FIB、D-D二聚体均明显高于Ⅱ组(P<0.05)。T_1～T_3时凝血酶原时间(PT)、部分凝血活酶时间(APTT)、凝血酶时间(TT)Ⅲ组明显短于Ⅰ、Ⅱ组,Ⅱ组明显长于Ⅰ组(P<0.05)。围术期出血量、输血量及24 h引流量Ⅲ组明显高于Ⅰ、Ⅱ组,Ⅰ组则明显高于Ⅱ组(P<0.05)。结论 UTI可以抑制凝血酶和凝血因子的激活,抑制纤溶系统的激活,保护血小板功能,改善凝血系统功能。5 kU/kg UTI可适当改善患者的凝血状态,而10kU/kg则对凝血功能有显著的改善。
Objective To investigate the influence of ulinastatin（UTI） on coagulation function of patients undergoing radical operation for malignant tumor. Methods Sixty ASA I or Ⅱ patients undergoing radical operation for abdominal malignant tumor were randomly divided into three groups. All groups were adopted tracheal intubation for general anesthesia. After anesthesia induction, patients in group I received intravenous UTI 5 kU/kg dissolved in 100 ml normal saline and group II received intravenous UTI 10 kU/kg dissolved in 100 ml normal saline; while those in group Ⅲ received equal volume of normal saline. Vein blood samples were collected at the time point of arrived in the room （T0）, resected tumor （T1）, after operation （ T2 ）, 24 h after operation （T3）, for measurement of blood routine and coagulation function. In the meantime, amount of bleeding, transfusion, infusion and bleeding through drainage tube 24 h after operation were recorded. Results The platelet count （Plt） at T1-T3 was decreased compared with To in all groups. Amplitude reduction of three groups was group Ⅲ 〉group I 〉group Ⅱ （P〈0.05）. PT, APTT,TT were much lower in group Ⅲ when compared with groups I and Ⅱ （P〈0.05）; FIB was increased at T1-T3 compared with T0（P〈0.05）,while groups I and Ⅱ were lower than group Ⅲ, and group I is higher than group Ⅱ（P〈0. 05） ;D-D dimer in all groups was increased at T1-T2, The uplift size was group Ⅲ ） group Ⅰgroup Ⅱ （P〈0.05）. Perioperative amount of bleeding, transfusion and bleeding through drainage tube 24 h after operation in group Ⅲ was higher than groups I and Ⅱ ,while group I was higher than groupⅡ （P^0. 05）. Conclusion UTI can inhibit the activation of thrombin and coagulation factor, protect Plt, improve coagulation system function. 5 kU/kg UTI can improve the coagulation of patients appropriately, and 10 kU/kg UTI can improve it markedly.
出处
《临床麻醉学杂志》
CAS
CSCD
北大核心
2012年第3期222-224,共3页
Journal of Clinical Anesthesiology
基金
陕西省社发攻关项目(项目编号:2007K09-07)
关键词
乌司他丁
凝血功能
恶性肿瘤根治术
Ulinastatin
Coagulation function
Radical operation for malignant tumor
