中国体外循环杂志Issue(4)：226-230,240,6.DOI:10.13498/j.cnki.chin.j.ecc.2014.04.09
深低温停循环下大剂量乌司他丁对A型主动脉夹层患者肺脏保护作用的研究
The protective effects of high-dose ulinastatin on pulmonary function in patients with type-A aortic dissection after cardiopulmonary bypass under deep hypot-hermic circulatory arrest
许崇恩 1张文龙 1张海洲 1王正军 1梁飞 1张军 1胡彬 1张刚 1邹承伟1
作者信息
- 1. 250021 济南，山东大学附属省立医院心外科
- 折叠
摘要
Abstract
[ Abstract]:Objective To investigate the protective effects of high-dose ulinastatin on the lung function in patients with aortic dissection after cardiopulmonary bypass (CPB) under deep hypothermic circulatory arrest (DHCA). Methods Thirty-six patients with acute type-A aortic dissection underwent cardiac surgery using CPB under DHCA. These patients were randomly selected to re⁃ceived total doses of 20,000 units/kg of ulinastatin ( ulinastatin group, n=18) or 0.9% saline ( control group, n=18) at 3 time points ( after anesthetic induction, before aortic cross-clamp, and after aortic cross-clamp released) . Tumor necrosis factor alpha ( TNF-α) , interleukin ( IL) -6, and IL-8 were measured after anesthetic induction ( T0) , 30 minutes ( T1) after aortic cross-clamp, 3 ( T2) , 6 ( T3) and 9 ( T4) hours after weaning from CPB. Except for T1, pulmonary datas, such as alveolar-arterial oxygen pressure differ⁃ence, physiologic dead space, peak inspiratory pressure, plateau pressure, static compliance and dynamic compliance, were obtained at the same time points. Results Concentrations of cytokines were significantly lower in the ulinastatin group than the control group from T1 to T4. Compared with the pulmonary data of the control group at T2-T4, postoperative alveolar-arterial oxygen pressure differ⁃ence, physiologic dead space, peak inspiratory pressure, and plateau pressure significantly were lower, and static compliance and dy⁃namic compliance were higher in the ulinastatin group. Significantly shorter intubation time and intensive care unit stay were found in the ulinastatin group. Conclusion High-dose ulinastatin attenuates the elevation of cytokines, reduces the pulmonary injury and im⁃proves the pulmonary function after CPB under DHCA. Consequently, it shortens the time of intubation and intensive care unit stay.关键词
体外循环/深低温停循环/乌司他丁/A型主动脉夹层Key words
Cardiopulmonreal bypass/Deep hypothermic circulatory arrest/Ulinastatin/Type-A aortic dissection引用本文复制引用
许崇恩,张文龙,张海洲,王正军,梁飞,张军,胡彬,张刚,邹承伟..深低温停循环下大剂量乌司他丁对A型主动脉夹层患者肺脏保护作用的研究[J].中国体外循环杂志,2014,(4):226-230,240,6.
