乌司他丁对乳腺癌患者围术期凝血功能的影响

The effect of Ulinastatin on coagulation function in patients with breast carcinoma during operation period

目的本研究拟通过观察乌司他丁（ulinastatin，UTI）对乳腺癌患者围术期凝血功能的影响，了解乌司他丁的血液保护机制。方法选择行乳腺癌改良根治术的患者40例，分为乌司他丁组（U组，n=20）和对照组（C组，n=20例），U组于麻醉后切皮前静脉输入乌司他丁4000U／kg，C组给予相同容量的生理盐水，所有患者分别于给药前（T0）和给药后1h（T1）抽取外周静脉血1ml，用Sonoclot凝血及血小板功能分析仪测定凝血激活时间（SonACT）、凝血速率（CR）、血小板功能（PF）。结果与C组比较，U组SonACT、PF在T1时增高，差异有统计学意义（P〈0．05）；与T0比较，U组SonACT在T1时延长（P〈0．05），PF在T，时增加（P〈0．01），差异有统计学意义。结论乌司他丁能改善围术期的凝血功能及血小板功能，可能对减少术中微血栓综合征，预防术后深静脉血栓形成有一定的临床意义。

Objective This trial was to observe the effect of Ulinastatin on coagulation functions in patients during operation period, and to investigate the protective mechanisms of Ulinastatin. Methods Forty patients were randomly divided into Ulinastatin group （ Group U, n = 20） and control group （ Group C, n = 20）. Group U was infused intravenously ulinastatin 4000 U/kg （ diluted with saline to 30 ml, 20 min losers） after anesthesia and before cutting skin, while Group C received the same volume of normal saline. All patients were phlebotomized 1 ml peripheral blood before administered （T0） and after 1 hour （T1）, respectively. Coagulation activation time （ SonACT）, clot rate （CR） and platelet function （PF） were detected by sonoclot coagulation analyzer and platelet function analyzer. Results Compared with group C （ controlled group）, SonACT of Group U was prolonged significantly at T1 （ P 〈 0. 05 ）, and PF were increased at T~ （ P 〈 0.05） ; Compared with T0, SonACT and PF were increased at T1 , respectively （ P 〈 0. 01 ）. Conclusions Ulinastatin can improve perioperative coagulation function and platelet function. It may reduce intraoperative micro-thrombosis syndrome and postoperative deep vein thrombosis.