乌司他丁对恶性梗阻性黄疸术后并发症的防治  

Prevention and cure effect of Ulinastatin on complications postoperation of malignant obstructive jaundice

作　　者：巩鹏[1] 王忠裕[1] 刘岳 王洪江[1] 李冰[1] 殷朔[1] 李克军[1] 赵荣宇[1] 

机构地区：[1]大连医科大学第一临床学院普外科,辽宁大连116011 [2]营口市第二人民医院外一科,辽宁营口11500

出　　处：《大连医科大学学报》2004年第2期98-101,共4页Journal of Dalian Medical University

基　　金：大连市科技项目 (982 0 2 1 )

摘　　要：[目的 ]探讨乌司他丁 (Ulinastatin ,UTI)对恶性梗阻性黄疸病人术后并发症的防治作用及作用机理。[方法 ]对 1 990年 1月～ 2 0 0 2年 3月恶性梗阻性黄疸行胆肠吻合术及胰十二指肠切除术的 1 98例病人术后每日消化液量、严重并发症及细胞因子水平等作回顾性分析总结。 [结果 ]术后 1周内 ,平均消化液量为 :乌司他丁治疗组 72 (例 )胃液 (32 4± 5 3) ,胆汁 (2 96± 4 3) ,胰液 (1 6 4± 1 0 )mL/d ,生长抑素治疗组 76(例 )胃液 (2 5 8± 4 6 ) ,胆汁 (2 0 1± 35 ) ,胰液 (4 0± 8)mL/d ,对照组 5 0 (例 )胃液 (74 4± 6 0 ) ,胆汁 (32 9±5 0 ) ,胰液 (2 5 4± 1 7)mL/d。乌司他丁治疗组明显少于对照组 (P <0 .0 1 )。在 1 98例病人中出现各种并发症 76例 ,发生率为 38.38% (76 / 1 98)。乌司他丁治疗组并发症 2 0例 ,发生率 2 7.78% (2 0 / 72 ) ,对照组 2 4例 ,发生率 4 8.0 % (2 4 / 5 0 ) ,乌司他丁治疗组明显低于对照组 (χ2 =5 .4 4,P <0 .0 2 5 )。乌司他丁治疗组胰瘘总发生率为 9.7% (7/ 72 ) ;对照组胰瘘总发生率为发生率为 1 6 .0 % (8/ 5 0 ) ,乌司他丁治疗组胰瘘的发生率 ,明显低于对照组 (χ2 =6 .6 3,P≤ 0 .0 1 ) ,但与生长抑素治疗组无显著性差异 (P >0 .0 5 )。术后第 3。Objective] To study the prevention and cure effect of Ulinastatin on the complications postoperation of malignant obstructive jaundice and its mechanism . [Methods] The dose of daily digestive juice、the incidence rate of severe complication and the level of cytokine of 198 patients diagnosised malignant obstructivejaundice performed by gallbladder jejunal anastomy and pancreaticoduodenectomy in our hospital from January 1990 to March 2003 were reviewed retrospectively. [Results] One hundred and ninetyeight cases were divided into 3 teams,team placebo 、team Ulinastatin and team somatostatin. The average dose of digestive juice in team Ulinastatin after a week blood were gastric juice (324±53)mL,bile (296±43)mL and pancreatic fluid (164±10)mL. The average dose of team Ulinastatin, 27.78%(20/72) was remarkable lower than that in team placebo ( P< 0.01).The incidence of postoperative complications in team Ulinastatin, 27.78%(20/72)was remarkable lower than that in team placebo (48.0%,24/50, P< 0.01). The level of blood serum interleukin 6(IL-6)、interleukin 8(IL-8)and tumor necrosis factor alpha(TNFα)were remarkable lower than that in team somatostatin. [Conclusion] Ulinastatin could effectively prevent and cure to postoperative complications of malignant obstructive jaundice through lessening excretion dose and concentration of pancreatic juice and reducing cytokine.

关 键 词：乌司他丁 梗阻性黄疸 并发症 细胞因子 防治 

分 类 号：R735[医药卫生—肿瘤]