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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P<0.05)。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。
Objective: To investigate the effects of ulinastatin on cardiopulmonary bypass and respiratory function in children with tetralogy of Fallot (CPR) during cardiopulmonary bypass. Methods: Sixty infants with tetralogy of Fallot who were treated in our hospital were enrolled in the study. They were randomly divided into control group and experimental group, with 30 cases in each group. The children in the experimental group received 10000 U / kg of ulinastatin daily before cardiopulmonary bypass and three days after the operation, while the control group received the same amount of saline at the corresponding time points. The clinicopathological parameters such as cardiopulmonary bypass time, cardiac arrest time, operation time, treatment time in the nursing home, postoperative hospital stay and the incidence of pulmonary infection in children were analyzed. Results: All patients were discharged. All the children in the control group had significantly lower operation time, cardiopulmonary bypass time and cardiac arrest time than those in the experimental group in the surgical operation and treatment effect. However, intensive care time and postoperative hospital stay were significantly higher than those in the experimental group. In the comparison of circulatory function after treatment in both groups, CVP and vasoactive drugs in the experimental group were lower than those in the control group While the MAP after ultrafiltration was significantly higher than that in the control group. In the comparison of respiratory function after treatment, the partial pressure of arterial oxygen in the experimental group was significantly higher than that in the control group and the experimental group Children’s postoperative mechanical ventilation time and the number of cases of pulmonary infection were lower than the control group of children, the difference between the two groups of children except operation time, cardiopulmonary bypass time and cardiac arrest time were statistically significant (P <0.05). CONCLUSION: Ulinastatin has a good protective effect on cardiopulmonary bypass and respiration during cardiopulmonary bypass in children with tetralogy of Fallot. It is worth to be widely used clinically.