Song J E, Kang W S, Kim D K, Yoon T G, Kim T Y, Bang Y-S, Kim S H
Department of Anaesthesiology and Pain Medicine, Konkuk University School of Medicine, Seoul, Republic of Korea.
J Int Med Res. 2011;39(4):1201-10. doi: 10.1177/147323001103900408.
This prospective, randomized, double-blind study evaluated the effect of ulinastatin on postoperative blood loss and transfusion requirements of patients undergoing open-heart surgery with cardiopulmonary bypass (CPB) and aortic cross-clamping (ACC). CPB and ACC produce variable systemic inflammatory reactions that are associated with multiorgan dysfunction via leucocytes, especially polymorphonuclear neutrophils (PMNs). PMNs increase blood loss and transfusion requirements. Ulinastatin, a urinary trypsin inhibitor, inhibits PMN activity and reduces the systemic inflammatory response. Patients received either 5000 U/kg ulinastatin or the equivalent volume of normal saline (control group) before ACC. Postoperative blood loss and transfusion requirements were recorded. Duration of intubation and length of stay in the intensive care unit (ICU) were also noted. There were no statistically significant between-group differences in postoperative blood loss and transfusion requirements. Ulinastatin caused a non-significant decrease in duration of intubation. Patients who received ulinastatin had significantly shorter ICU stays than control patients.
这项前瞻性、随机、双盲研究评估了乌司他丁对接受体外循环（CPB）和主动脉交叉钳夹（ACC）的心脏直视手术患者术后失血量和输血需求的影响。CPB和ACC会产生多种全身炎症反应，这些反应通过白细胞，尤其是多形核中性粒细胞（PMN）与多器官功能障碍相关。PMN会增加失血量和输血需求。乌司他丁是一种尿胰蛋白酶抑制剂，可抑制PMN活性并减轻全身炎症反应。患者在ACC前接受5000 U/kg乌司他丁或等量生理盐水（对照组）。记录术后失血量和输血需求。还记录了插管时间和在重症监护病房（ICU）的住院时间。术后失血量和输血需求在组间无统计学显著差异。乌司他丁使插管时间有不显著的缩短。接受乌司他丁治疗的患者在ICU的住院时间明显短于对照组患者。
