乌司他丁对高龄食管癌患者术后肺肝肾功能的影响  

Effects of ulinastatin on pulmonary and hepatorenal function of elderly patients undergoing resection of esophageal cancer

作　　者：熊雪梅[1] 吴蔚[1] 夏梅[1] 王华[1] 

机构地区：[1]第三军医大学西南医院心胸外科,重庆400038

出　　处：《中华消化外科杂志》2009年第5期374-376,共3页Chinese Journal of Digestive Surgery

摘　　要：目的研究乌司他丁对高龄食管癌患者术后肺、肝、肾功能的影响。方法收集2005年1月至2008年1月第三军医大学西南医院收治的40例高龄食管癌患者的临床资料，按照随机数字表法分为对照组、乌司他丁组。两组患者均于术后给予7d全胃肠外营养（TPN），其中乌司他丁组同时给予乌司他丁40万U／d静脉滴注。分别于术前及术后第2天、第6天晨抽取两组患者的动、静脉血测量PaO2、PaCO2、氧分压／吸人气体氧含量（PaO2／FiO2）、ALT、AST、TBil、尿酸、尿素氮、肌酐。采用t检验和X^2检验分析结果。结果术后第6天，乌司他丁组和对照组的PaO2分别为（87．3±4．2）mmHg（1mmHg=0．133kPa）和（79．0±4．3）mmHg，PaO2／FiO2分别为（416±20）mmHg和（376±20）mmHg；两组比较差异有统计意义（t=6．2，6．2，P〈0．05）。乌司他丁组和对照组的ALT分别为（23±7）U／L和（39±8）U／L，AST分别为（38±8）U／L和（50±9）U／L，TBil分别为（13．4±3．0）umol／L和（24．5±6．0）umol／L，两组比较差异有统计学意义（t=7．0，4．4，7．6，P〈0．05）。乌司他丁组和对照组的尿酸分别为（279±84）umol／L和（386±67）umol／L，尿素氮分别为（4．1±1．7）mmol／L和（8．9±2．7）mmol／L，肌酐分别为（66±12）umol／L和（95±38）umol／L，两组比较差异有统计学意义（t=4．4，6．4，3．3，P〈0．05）。乌司他丁组并发症发生率低于对照组（r=4．8，P〈0．05）。结论在术后常规行TPN治疗的基础上，应用乌司他丁可以更好地保护和改善高龄食管癌患者的肺、肝、肾功能。Objective To investigate the effects of ulinastatin on pulmonary and hepatorenal function of elderly patients undergoing resection of esophageal cancer. Methods The clinical data of 40 elderly patients with esophageal cancer who had been admitted to Southwest Hospital from January 2005 to January 2008 were retrospectively analyzed. All the patients were randomly divided into control group （n = 20） and ulinastatin group （n = 20 ） according to random number table. Patients were administered with total parenteral nutrition, and patients in ulinastatin group were additionally instilled with 4 × 10^5 U/d of ulinastatin. The levels of PaO2, PaCO2, PaO2/FiO2, alanine aminotransferase （ALT） , aspartate aminotransferase （AST） , total bilirubin （TBil） , blood urea nitrogen, creatinine and uric acid were detected preoperatively and at postoperative day 2 and day 6. All the data were analyzed by t-test and chi-square test. Results The levels of PaO2 and PaO2/FiO2 were （ 87.3 ± 4.2 ） mm Hg （1 mmHg =0. 133 kPa） and （416 ±20）mm Hg in ulinastatin group, which were significantly higher than （79.0 ± 4.3） mmHg and （376 ± 20） mmHg in control group （ t = 6. 2, 6. 2, P 〈 0.05 ）. The levels of ALT, AST and TBil were （23 ±7）U/L, （38 ±8）U/L and （13.4 ±3.0） umol/L in ulinastatin group, and （39 ±8） U/L, （50 ± 9） U/L and （24.5 ± 6.0 ） umol/L in control group, with signifieant difference between the 2 groups （ t = 7. 0, 4. 4, 7. 6, P 〈 0.05 ）. The levels of uric acid, blood urea nitrogen and creatinine were （279 ± 84）umol/L, （4.1 ± 1.7 ） mmol/L and （66 ± 12）umoL/L in ulinastatin group, and （ 386 ± 67 ） umol/L, （ 8.9 ± 2.7 ） mmol/L and （95 ± 38 ） umoL/L in control group, with significant difference between the 2 groups （ t = 4. 4, 6. 4, 3.3, P 〈 0.05 ）. The reeurrence of eomplications in ulinastatin group was significantly lower than that in control group （X^2 = 4. 8, P 〈 0.05）. Conclusion Postoperative supplementat

关 键 词：食管肿瘤 乌司他丁 高龄患者 

分 类 号：R735[医药卫生—肿瘤]