大剂量乌司他丁对直肠癌患者术中凝血状态的影响  

Effects of high-dose ulinastatin on blood coagulation during surgery in patients with rectal cancer

作　　者：吴群林[1] 屠伟峰[1] 施冲[1] 

机构地区：[1]广州军区广州总医院麻醉科,510010

出　　处：《实用医学杂志》2013年第14期2241-2242,共2页The Journal of Practical Medicine

摘　　要：目的:观察大剂量乌司他丁对直肠癌患者术中凝血状态的影响。方法:选择拟行直肠癌根治性手术40例(Dixon),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20min内滴注乌司他丁10000U/kg或生理盐水各100mL。分别于给药前(T0)、给药后1h(T1),用SONOCLOT凝血仪测定ACT,CR,PF;2h(T2)后测定D二聚体,术毕记录失血量。结果:与T0时比较,U组ACT,CR,PF在T1时明显升高(P<0.01或P<0.05)。D-二聚体U组和N组均升高(P<0.05),D-二聚体U组比N组显著低(P<0.01),U组比N组出血量明显减少(P<0.05)。结论:乌司他丁可升高直肠癌手术患者的ACT,CR,PF,抑制纤维蛋白的分解,减少手术出血量。Objective To investigate the effects of high-dose ulinastatin on blood coagulation during surgery in patients with rectal cancer.Methods 40 patients（TNM Ⅱ or Ⅲ）,scheduled for radical resection of rectal cancer（Dixon）,were randomly divided into 2 groups（each n = 20）：ulinastatin group（Group U） and normal saline group（Group N）.Patients in Group U were given 10 000 U /kg of ulinastatin,while those in Group N received 100 mL of normal saline intravenously within 20 min.Activated clotting time（ACT）,clotting rate（CR）,and platelet function（PF） in the two groups were detected by Sonoclot coagulometer respectively at pre-infusion（T0）,1 hour after the infusion（T 1）.D-dimer（D-D） was measured at T0and 2 hour after the infusion（T2）.Blood loss was also recorded.Results As compare with those at T0,ACT,CR and PF were increased at T1（P〈0.05 or P〈0.01） in Group U.At T2,D-D in Group N and Group U were obviously increased（P〈0.05）,and that in Group N was higher（P〈0.01）.Blood loss in Group N was more than that in Group U.Conclusion Ulinastatin may improve the blood coagulation state for patients undergoing rectal cancer surgery through increasing ACT,CR and PF,and then inhibiting the decomposition of fibrin.

关 键 词：乌司他丁 血液凝固 血小板功能试验 

分 类 号：R614[医药卫生—麻醉学]