乌司他丁对体外循环法洛四联症患儿围心脏手术期循环和呼吸功能的影响

目的:探讨乌司他丁对体外循环法洛四联症患儿围心脏手术期循环和呼吸功能的影响。方法:选取我院于收治的60例法洛四联症婴幼儿参与研究,并将其随机分为对照组和试验组两组,每组患儿30例。其中试验组患儿在体外循环前以及患儿进行手术后的三天内每天均给予10000U/kg乌司他丁,而对照组患儿则在相应的时间点给予等量的生理盐水。分析比较两组患儿的体外循环时间、心脏停搏时间、手术时间、在监护室治疗的时间以及患儿术后住院时间和患儿肺部感染发生例数等临床病理情况。结果:所有入选患儿均痊愈出院,在两组患儿的手术操作情况和治疗效果对比中,对照组患儿的手术时间、体外循环时间和心脏停搏时间均显著低于试验组患儿,但重症监护时间及术后住院时间则高于试验组患儿;在两组患儿治疗后的循环功能指标比较中,试验组患儿超滤后CVP和血管活性药物均低于对照组患儿而超滤后MAP则显著高于对照组患儿;在两组患儿治疗后的呼吸功能指标的比较中,试验组患儿的动脉血氧分压明显高于对照组患儿以及试验组患儿的术后机械通气时间和肺部感染例数均低于对照组患儿,两组患儿的数据比较差异除手术时间、体外循环时间和心脏停搏时间外均具有统计学意义(均P0.05)。结论:乌司他丁对体外循环法洛四联症患儿围心脏手术期的循环和呼吸功能具有较好的保护作用,值得在临床上加以广泛推广和运用。

Effects of Ulinastatin on Circulatory and Respiratory Function ofCardiopulmonary Bypass Children with Tetralogy of Fallot duringPerioperative Cardiac Surgery

Objective:To investigate the effects of ulinastatin on circulatory and respiratory function of children with tetralogy ofFallot in the perioperative period of cardiopulmonary bypass cardiac surgery.Methods:A total of 60 cases of tetralogy of Fallot infantsand young children from our hospital were included in the study, and were randomly divided into control group and experimental group,with 30 cases in each group. The children in the experimental group were given 10000 U/kg Ulinastatin per day before CPB and withinthree days after surgery, while those in control group were given equal volume of normal saline at the corresponding time. Analyze andcompare the clinical pathology indicators such as cardiopulmonary bypass time, time of cardiac arrest, operation time, ICU treatmenttime, postoperative hospitalization time and cases with pulmonary infection between the two groups.Results:All enrolled patients werecured and discharged. Patients in control group had significantly shorter surgery time, cardiopulmonary bypass time and cardiac arresttime than children in the experimental group, but longer intensive care time and postoperative hospitalization time than those in theexperimental group. As for the circulatory function indexes after treatment, the levels of CVP and vasoactive drugs after ultrafiltrationwere lower in the experimental group than children in the control group, while the mean arterial pressure (MAP) after ultrafiltration wassignificantly higher than that of patients in the control group. In comparison of the respiratory function index, the arterial partial pressureof oxygen in the experimental group was significantly higher than in the control group. Patients in experimental group also had lesspostoperative mechanical ventilation time than those in the control group. There were less pulmonary infection cases in the experimentalgroup, too. Differences between the two groups had statistical significance except the data of operation time, cardiopulmonary bypasstime and cardiac arrest time (all P<0.05).Conclusion:Ulinastatin had good protective effect on the circulatory and respiratory function ofcardiopulmonary bypass children with tetralogy of Fallot during cardiac surgery. It is deserved to be widely popularized and applied inclinic.