小儿室间隔缺损修补术中乌司他丁及氨甲环酸联用的效果及临床意义

发布时间：2018-06-07 04:00

本文选题：乌司他丁 + 氨甲环酸　；参考：《山东医药》2015年42期

【摘要】：目的观察小儿室间隔缺损修补术中联合应用乌司他丁及氨甲环酸的临床效果,探讨其临床意义。方法选取室间隔缺损患儿200例,按照随机数字法分为A组、B组、C组及对照组,每组各50例。择期行室间隔缺损修补术,四组均于麻醉诱导后给药:A组静脉注射乌司他丁10 000 U/kg,B组静脉注射氨甲环酸注射液20 mg/kg,C组静脉注射氨甲环酸注射液20 mg/kg及乌司他丁10 000 U/kg,对照组静脉注射同等体积生理盐水。记录术中心包引流量及冰冻血浆输注量。手术前及手术结束12 h后自中心静脉导管取血,检测血清炎症指标(TNF-α、IL-6、IL-10)及凝血指标(中性粒弹性蛋白酶、PT、APTT)。结果 A、B、C组术中心包引流量及冰冻血浆输注量均少于对照组,且C组少于A、B组(P均0.05)。A、B、C组血清TNF-α及IL-6水平均低于对照组,且C组低于A、B组;A、B、C组血清IL-10水平高于对照组,且C组高于A、B组;A、B、C组血清弹性蛋白酶水平、PT、APTT均低于对照组,且C组低于A、B组(P均0.05)。结论小儿室间隔缺损修补术中联合应用乌司他丁及氨甲苯酸具有较好的止血作用,可减少术中心包引流量及输血量,可能与促进凝血功能及抑制炎症反应有关。
[Abstract]:Objective To observe the clinical effect of combined use of ulinastatin and methiculic acid in pediatric ventricular septal defect repair, and to explore its clinical significance. Methods 200 children with ventricular septal defect were selected and divided into group A, group B, group C and control group, 50 cases in each group. The four groups were given anesthetic induction after anesthesia. Group A was intravenously injected with ulinastatin 10000 U/kg, group B was intravenously injected with Tranexamic Acid Injection 20 mg/kg, group C was intravenously injected with Tranexamic Acid Injection 20 mg/kg and ulinastatin (Ulinastatin), and the control group was injected with the same volume of normal saline. The flow rate and plasma infusion volume were recorded at the center of the operation and the concentration of frozen plasma was recorded before and after the operation and after the operation ended 12 h. Serum inflammation index (TNF- alpha, IL-6, IL-10) and coagulation index (neutrophilic elastase, PT, APTT) were measured. Results A, B, C group were less than the control group, and the C group was less than A, B group (P mean 0.05) was lower than the control group. Serum IL-10 level was higher than that of control group, and C group was higher than A, B group, A, B, C group were lower than control group, PT, APTT were lower than that of control group, and C group was lower than A, B group (all 0.05). Conclusion the combined use of ulinastatin and aminobutyric acid in the repair of ventricular septal defect in children has a better hemostatic effect and can reduce the flow rate and blood transfusion in the operation center. It can be related to promoting coagulation function and inhibiting inflammatory reaction.
【作者单位】：河北省儿童医院;河北省胸科医院;
【基金】：河北省医学科学研究重点课题计划资助项目(20110015)
【分类号】：R726.5

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