乌司他丁对脊柱手术患者围术期凝血功能的影响与分析  

Influence of ulinastatin on perioperatiive coagulation system in spine surgery

作　　者：张进[1] 王育明[1] 张绍杰[1] 

机构地区：[1]武警广东省总队医院麻醉科,广东广州510507

出　　处：《中国医院药学杂志》2014年第5期399-401,共3页Chinese Journal of Hospital Pharmacy

摘　　要：目的:探讨乌司他丁对脊柱手术患者凝血功能的影响。方法:选择90例脊柱大手术患者,按照数字随机法分为3组,每组各30例:UTI 5 kU·kg-1(A组,以生理盐水稀释到100 ml)、UTI 10 kU·kg-1(B组,以生理盐水稀释到100 ml)和对照组(C组,生理盐水100 ml)。3组均于麻醉后(手术前)静脉输注(20 min内输完)。分别于麻醉前(T0)、术毕(T1)、术后24 h(T2)采集3组患者外周静脉血8 ml,检测红细胞压积(Hct)、血红蛋白(Hb)、血小板计数(Plt)、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)、凝血酶时间(TT)及D-二聚体(D-D)。结果:(1)T0时3组Htc、Plt、PT、APTT、TT、FIB、D-D均无明显区别(均P>0.05);(2)T1和T2时间点时A组、B组PT、APTT、TT均明显长于C组(均P<0.05),而FIB、D-D则明显低于C组(均P<0.05);(3)术毕(T1)、麻醉前(T2)时B组的APTT、PT均明显长于A组(均P<0.05),而D-D则明显低于A组(均P<0.05)。结论:乌司他丁可纠正血液高凝状态,减少术后深静脉血栓(DVT)的形成。OBJECTIVE To explore the influence of Ulinastatin （UTI） on perioperatiive coagulation system in spine surger y. METHODS Nighty patients of spine surgery were selected and randomly divideded into 3 groups each contained 30 patients： Group A received intravenous infusion of UTI （5 kU. kg^-1）, Group B received intravenous infusion of UTI 10 kU.kg^-1 and Group C received the same volumn of normal saline （control group）. All drugs were infused in 20 minutes before operation. Blood sample were taken before operation （To）, at the end of surgery（T1 ）, 24h after operation （T3） for determination the val ues of Htc, Pit, PT, APT＇I＇, ＂IT, FIB and D-D. RESULTS （1）There were no significant differences among 3 groups at To （all P〉0. 05）. （2）Compared with group （2, the values of PT, APTT, TT in group A and B were higher （all P〉0. 05）, and the values of FIB and D-D were lower （all P〈0. 05）. （3）Compared with group A, the values of PT and APTT were higher （both P%0. 05）, and D-D was lower （P〈50. 05）. CONCLUSION Intravenous infusion of UTI can correct the hypercoagulability of blood and decrease the incidence of DVT after operation.

关 键 词：乌司他丁 脊柱手术 凝血功能 

分 类 号：R969[医药卫生—药理学]