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目的探讨乌司他丁在婴幼儿心肺转流(CPB)围术期对血小板功能的保护及止血作用。方法45例3岁以下房间隔缺损(ASD)或室间隔缺损(VSD)患儿随机分为三组,每组15例,分别在预充液中一次性加入抑肽酶(A组)、乌司他丁(U组)或未用药(C)组;选取4个时间点采静脉血测定血小板膜糖蛋白受体GPⅠb和GPⅡb/Ⅲa及血小板计数;记录术后纵隔引流量及输血量。结果GPⅠb、GPⅡb/Ⅲa组内及A、U组与C组之间比较有统计学意义(P<0.01),A组与U组间无统计学意义。血小板计数组间比较无统计学意义。A、U组术后纵隔引流量明显少于C组(P<0.05),U组与A组间无统计学意义。三组术后输血量无统计学意义。结论乌司他丁在婴幼儿先心病围术期通过保护GP而对血小板功能有部分保护作用,从而减轻术后非外科性出血,减少输血量,可取代抑肽酶作为婴幼儿先心病手术的血液保护用药。
Objective To investigate the protective and hemostatic effects of ulinastatin on platelet function during cardiopulmonary bypass (CPB) in infants and young children. Methods Forty-five children with atrial septal defect (ASD) or ventricular septal defect (VSD) under 3 years old were randomly divided into three groups (n = 15 each). Aprotinin (group A) (U group) or no drug group (C). Four venous blood samples were taken for determination of platelet glycoprotein receptor GPⅠb and GPⅡb / Ⅲa and platelet count. Mediastinal drainage and transfusion volume were recorded. Results There was a significant difference between GPⅠb, GPⅡb / Ⅲa group and A, U group and C group (P <0.01). There was no significant difference between A group and U group. Platelet count between the groups was not statistically significant. The drainage of mediastinal in group A and U was significantly less than that in group C (P <0.05). There was no significant difference between group U and group A. Three groups of postoperative blood transfusion was not statistically significant. Conclusion Ulinastatin can protect platelet function by protecting GP in the perioperative period of infants with congenital heart disease, so as to reduce postoperative non-surgical bleeding and blood transfusion and replace aprotinin as an infant with congenital heart disease Blood protection medication.