乌司他丁对严重创伤手术患者肝肾功能的保护作用

Protective effect of ulinastatin on liver and renal functions in severe trauma patients underwent emergency surgery

目的观察在抢救急诊创伤患者麻醉过程中应用乌司他丁对患者肝肾功能的保护作用。方法严重创伤急诊手术60例患者均分为病情相仿的三组：A组术后采用常规治疗;B组加用乌司他丁10万U,溶于生理盐水500ml静脉滴注,每次静脉滴注1~2h,每日1次;C组加用乌司他丁10万U,每日3次。测定内生肌酐清除率（Ccr）、ALT、AST和血清总胆红素（TBil）。记录脱离呼吸机时间和ICU住院时间。结果术后第1天和第2天B、C组的Ccr高于A组,ALT、AST和TBil均低于A组（P〈0.05）,B、C组ICU停留时间也短于A组（P〈0.05）。结论乌司他丁对严重创伤急诊手术患者的肝肾功能有一定保护作用。

Objective To observe the protective effect of ulinastatin on liver and renal function in severe trauma patients underwent emergency surgery.Methods Sixty patients with severe trauma underwent emergency operation were equally and randomly assigned into three groups.The patients in group A were treated conventionally as the controls,those in group B were given additional ulinastatin100 000 U once a day for two days after operation,and those in group C were given additional ulinastatin 100 000 Uthree times a day for two days.Ulinastatin 100 000 U was put into normal saline and infused in two hours.Creatinine clearance（Ccr）,ALT,AST,and total bilirubin（TBil）were detected on the 1st and 2nd day after operation.The weaning time from ventilator and ICU stay time were recorded.Results Seum levels of ALT,AST,and TBil on the 1st and 2nd day after operation were all lower,while Ccr was higher,in groups of B and C than those in group A（P〈0.05）.ICU stay time was shorter in groups of B and C than that in group A（P〈0.05）.Conclusion Ulinastatin has a certain protective effect on the liver and renal function in severe trauma patients underwent emergency surgery.