摘要：目的 观察乌司他丁和抑肽酶对体外循环(CPB)心脏手术的血液保护作用。方法 选择60例风湿性心脏病瓣膜置换术的病人，随机分成3组。乌司他丁组(20例)：给予乌司他丁12000 U/kg，于麻醉诱导后至CPB开始前缓慢静注半量，另半量加入预充液中随转机进入体内；抑肽酶组(20例)：于CPB中一次性给抑肽酶500万单位；对照组(20例)：给予等量生理盐水。结果 与对照组相比，乌司他丁组术后24h胸液量减少33.3% (P<0.05)，抑肽酶组术后24h胸液量减少39.8%(P<0.05)，乌司他丁组与抑肽酶组相比无统计学差别。抑肽酶组有一例发生严重过敏。结论 乌司他丁和抑肽酶均有维持纤溶活性稳定、保护血小板功能，从而减少术中及术后出血。

    关键词：心肺转流术，乌司他丁，抑肽酶

    The Protection of Ulinastatin and Aprotinin on Blood Fibrinolytic

    System During Cardiopulmonary Bypass

    ZHAI Yu-jia, WANG Xiao-lei

    (Department of Anesthesiology Sun Yetsen Cardiovascular hospital,Guang Dong Shenzhen 518020 China)

    Abstract: OBJECTIVE To observe the protection of ulinastatin and aprotinin on blood fibrinolytic system during cardiopulmonary bypass . METHODS Sixty patients were divided into three groups: ulinastatin group(n=20) : patients received ulinastatin 6000 IU/kg iv after induction of anesthesia and another 6000 IU/kg was added into the priming solution ; aprotinin group(n=20) : patients received aprotinin 2×10 KIU in pump prime ; control group(n=20) : patients received equal volume of normal saline . RESULTS As compared with the control group , there were significant decrease in 24-hours chest tube drainage in ulinastatin group (33.3% reduction) , and 39.8% reduction in 24-hours chest tube drainage in aprotinin group. CONCLUSION Ulinastatin and aprotinin are effective in stabilizing fibrinolytic system and preserving platelet function during CPB ,leading to less postoperative blood loss . ......