Objective To study the protective effect of ulinastatin on lung in patients with type A aortic dissection during deep hypothermic circulatory state. Methods A total of 120 patients with type A aortic dissection were selected and were randomly divided into observation group and control group, with 60 cases in each group. The lung function and other indexes of the two groups were recorded and compared. Results At 30 minutes after aorta occlusion,6 hours and 24 hours after operation,the levels of tumor necrosis factor - α (TNF - α)and interleukin - 6 (IL - 6)in observation group were signifi-cantly lower than those in control group,but the concentration of interleukin - 10 (IL - 10)was higher in the control group than that in the control group (P < 0. 05). Before the departure of room,6 hours and 24 hours after operation,the peak inspiratory pressure (PIP),pulmonary alveolar oxygen pressure differ-ence (A - aDO2)and physiological dead space (VD/ VT)in observation group were lower than those in control group,but the static lung compliance (Cs)and dynamic lung compliance (Cd)were all higher than those in control group (P < 0. 05). The incidence of postoperative pulmonary complications in ob-servation group was lower than that in control group,and the hospitalization time was shorter than that in control group (P < 0. 05). Conclusions The use of ulinastatin in the operation of type A aortic dissec-tion is helpful to alleviate the systemic inflammatory reaction in the operation,reduce the lung injury and promote postoperative rehabilitation,which is worth popularizing.%目的 探讨A型主动脉夹层患者在深低温停循环状态下手术使用乌司他丁对肺脏的保护作用.方法 选取A型主动脉夹层患者120例,按随机数字表法分为观察组和对照组,每组60例.统计并比较两组的肺功能指标.结果 主动脉阻断后30 min、离室前、术后6 h、术后24 h,观察组肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)水平均低于对照组,且白细胞介素-10(IL-10)水平均高于对照组(P均<0.05);离室前、术后6 h、术后24 h,观察组吸气峰压(PIP)、肺泡-动脉氧分压差(A-aDO 2)、生理死腔(VD/VT)均低于对照组,且静态肺顺应性(Cs)、动态肺顺应性(Cd)均高于对照组(P均<0.05);观察组术后肺部并发症发生率低于对照组,住院时间短于对照组(P<0.05).结论 乌司他丁用于A型主动脉夹层患者术中有助于减轻患者的全身炎症反应,减轻肺脏损害,促进术后康复,值得临床推广.
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