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目的观察乌司他丁对胃癌患者术后肝肾功能保护作用的临床疗效。方法选择同期行D2式胃癌根治性手术患者40例,随机分为治疗组(n=20)和对照组(n=20)。治疗组在术后1～3d每天予以生理盐水100ml加乌司他丁20万U静脉滴注,对照组仅给100ml生理盐水静脉滴注。同期检测治疗组和对照组手术前后血红蛋白、血清白蛋白、肝肾功能。结果治疗组术后第5天血红蛋白较术前明显升高(P<0.05),而对照组血红蛋白无明显改变;治疗组白蛋白仅在术后1d显著下降(P<0.01),术后3、5d与术前无明显差异,对照组术后1、3、5d白蛋白较术前显著下降(P<0.01);两组术后血清ALT水平较术前均有所升高但无统计学意义,但治疗组升高的幅度均小于对照组,治疗组TBIL水平术后第一天明显上升(P<0.01),随后即下降与术前无差异,对照组TBIL水平无明显改变;治疗组术后1～3d血清Cr水平明显下降与术前相比差异有统计学意义(P<0.01),而BUN较术后无明显下降,差异无统计学意义(P>0.05);对照组术后血清Cr、BUN水平较术前明显升高(P<0.01),但与治疗组同期相比差异无统计学意义(P>0.05)。结论乌司他丁可以明显改善胃癌患者的蛋白质代谢异常并对患者的肝肾功能有一定的保护作用。
Objective To observe the clinical effect of ulinastatin on liver and renal function in patients with gastric cancer after operation. Methods Forty patients with radical surgery of D2 gastric cancer were randomly divided into treatment group (n = 20) and control group (n = 20). In the treatment group, 100ml of saline plus 200,000 U of ulinastatin was intravenously dripped every day, and the control group received only 100ml of saline. In the same period, the hemoglobin, serum albumin and liver and kidney function of the treatment group and the control group before and after operation were detected. Results The hemoglobin of the fifth day after operation in the treatment group was significantly higher than that before the operation (P <0.05), while the hemoglobin in the control group had no significant change. The albumin of the treatment group decreased significantly only 1 day after operation (P <0.01) There was no significant difference between preoperative 5d and preoperation (P <0.01). The levels of serum ALT in both groups were significantly increased at 1, 3 and 5 days after operation , But the treatment group increased less than the control group. The TBIL level in the treatment group increased significantly on the first day after operation (P <0.01), and then decreased no difference with the preoperative TBIL level in the control group. The treatment group There was a significant difference in serum Cr levels 1 ~ 3 days after operation compared with that before operation (P <0.01), while BUN had no significant difference after operation (P> 0.05). The postoperative serum Cr and BUN levels were significantly higher than those before operation (P <0.01), but there was no significant difference compared with the treatment group (P> 0.05). Conclusion Ulinastatin can significantly improve the abnormalities of protein metabolism in gastric cancer patients and protect the liver and renal function of patients.