摘要
目的观察乌司他丁对人工关节置换术患者凝血和纤溶系统的影响。方法选择60例无血液疾病及凝血功能障碍、肝肾功能异常或服用相应药物的择期行全髋、半髋关节、人工股骨头置换术的骨科患者[美国麻醉师协会(ASA)Ⅰ～Ⅱ],随机分为乌司他丁组(Ⅰ组,n=30)和生理盐水组(Ⅱ组,n=30),分别在围术期静脉注射乌司他丁和生理盐水。在给药前(T0)、给药后1 h(T1)、给药后2 h(T2)采血测定凝血酶原时间(PT)、部分凝血活酶时间(APTT)、凝血酶时间(TT)、纤维蛋白原(FIB)、国际标准化比率(INR)及血小板的最大聚集率(PAGM)。结果与T0时比较,乌司他丁组T1时APTT、PT明显延长(P<0.05);T2时TT明显延长(P<0.05);与生理盐水组比较,T1时PT、APTT显著性延长(P<0.01);T2时PT、TT明显延长(P<0.05),两组用药前后及组间比较PAGM差异均无显著性。结论围术期静脉滴注5 000 U/kg乌司他丁可降低人工关节置换术患者术中的高凝血状态,预防术后深静脉血栓形成有积极作用。
Objective To investigate the effect of ulinastatin （UTI） on human blood coagulation and fibrinolysis system in total joint arthroplasty. Methods Sixty ASA I -II orthopedics patients were randomly divided into UTI group （ n = 30） in which patients were given UTI 5 000 U/kg and control group （ n = 30） in which patients were given NS 100 ml. PT, TT, APTT, IB, INR and PAGM were measured at pre - infusion（T0） ,1 hour after UTI infusion （T1） and2 hours after UTI infusion （3＂2）. Results APTIP and PT at T1（ P 〈0.05） , and TT at T2 （ P 〈0.05） were prolonged significantly than the baseline at T0. Compared with control group, APTT and PT at T1（ P 〈0.01）, and PT and TT at T2 （ P 〈 0.05 ） were prolonged significantly. There was no difference in PAGM between two groups. Conclusion UTI 5 000 U/kg can improve hypercoagulative status of patients during total joint artbroplasty, which may prevent deep vein thrombosis after surgery.
出处
《临床和实验医学杂志》
2012年第18期1451-1452,1455,共3页
Journal of Clinical and Experimental Medicine
