Objective:To study the ulinastatin and propylene ammonia acyl glutamine for extracorporeal circu-lation valve replacement patients .Methods :Selected our hospital in extracorporeal circulation (CPB) downlink of 60 cases of patients with valve replacement .According to random number table method was divided into observation group and control group with 30 cases in each .All patients were given anesthesia induction and operation were in the process of joining ulinastatin 20000 U/kg ,the observation group based on the pump injection propylene ammonia ac-yl glutamine 0 .4 g/(kg · d) .Respectively compared two groups of aorta blocking time ,CPB time ,operation time , different times of serum IL-6 ,TNF-α,SP-A level and A-aDO2 ,RI value ,Oxygenation index ,mechanical ventilation time and postoperative live time of ICU .Results :Compared the two groups of T2 to T5 in the group A-aDO2 ,RI values ,Oxygenation index were significantly higher than that of the T 0 ,and observe A-the set of T2 to T5 aDO2 ,RI values were significantly lower than the control group ,Oxygenation index was significantly higher than that of con-trol group ,the difference had statistical significance (P<0 .05) .Compared the two groups of T2 to T5 serum IL-6 , TNF-α,SP-A level were significantly higher than that of the T0 ,and observation group of T2 to T5 serum IL-6 , TNF-α,SP-A level were significantly lower than the control group ,the difference had statistical significance (P<0 . 05) .Observation group of postoperative mechanical ventilation time for (10 .0 ± 0 .7) h ,significantly lower than the control group (14 .5 ± 1 .0) h ,the difference was statistically significant (P< 0 .05) .Conclusion :Ulinastatin and propylene ammonia acyl glutamine can effectively inhibit extracorporeal circulation valve replacement in patients with inflammatory reaction ,has significant lung protection .%目的:研究乌司他丁及丙氨酰谷氨酰胺对体外循环瓣膜置换术患者的肺保护作用.方法:选取体外循环(C PB)下行瓣膜置换术患者60例,根据随机数字表法分为观察组和对照组各30例.所有患者均给予麻醉诱导,手术过程中均加入乌司他丁2万U/kg,观察组在此基础上泵注丙氨酰谷氨酰胺0.4g/(kg·d).分别对比两组主动脉阻断时间、CPB时间、手术时间,不同时间段血清IL-6、TNF-α、SP-A水平与A-aDO2、RI值、氧合指数,术后机械通气时间以及住ICU时间.结果:两组组内T2~T5时A-aDO2、RI值、氧合指数均显著高于T0时,而观察组T2~T5时A-aDO2、RI值均显著低于对照组,氧合指数显著高于对照组,差异均有统计学意义(P<0.05).两组组内T2~T5时血清IL-6、TNF-α、SP-A水平均显著高于T0时,而观察组T2~T5时血清IL-6、TNF-α、SP-A水平均显著低于对照组,差异均有统计学意义(P<0.05).观察组术后机械通气时间(10.0±0.7)h,显著低于对照组(14.5±1.0)h,差异有统计学意义(P<0.05).结论:乌司他丁及丙氨酰谷氨酰胺可有效抑制体外循环瓣膜置换术患者的炎症反应,具有显著的肺保护作用.
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