The Clinical Observation Of The Recovery Of Lung Function After Using Ulinastatin During Cardiopulmonary Bypass After Heart Valve Replacement

Objective Through the clinical observation of the recovery of lung function after using Ulinastatin during Cardiopulmonary Bypass after Heart Valve Replacement,to seek measures of lung injury in the prevention and treatment after CPB, and to provide clinical evidence for heart disease postoperative pulmonary function restore and postoperative care.Methods Selected60patients,who had underwent cardiac valve replacement with the CPB assisted at cardiac surgery department of Affiliated Hospital of Ningxia Medical University,and patients who meet the requirements by randomly divided into an experimental group(n=30) and control group(n=30).During the traditional treatment of the experimental group, The Ulinastatin at the commencement of CPB and the aortic opening was added to10000U/kg and200000U each time into the intensive care unit, intravenous injection of treatment by Q12h. The Control group with saline treatment under the same conditions. Observed before and after CPB each time point of blood gas analysisvalues by1h,12h,24h,48h, and to calculate the difference PA-aO2to arrive at the oxygenation index and the respiratory index. The changes of chest X-ray to the chest radiograph in the clear patches shadow, atelectasis positive after surgery bylh,24h. Ventilation time;Leave ICU; Hospitalization time; Complication rates.Results the preoperative general condition of the patients was no statistically significant(P>0.05),Ventilation time and Leave ICU and Hospitalization time of the two groups compared were statistically significant (P<0.05). The changes of chest X-ray after24h:The experimental group for lung markings, The control group increased exudation sheet. The Complication rates with each other statistically significant (P<0.05).The Control Group:Compared with preoperation in PaO2after CPB by12h and24h were significantly lower statistically significant(P<0.05); and Compared with preoperation in PA-aO2was significantly lower statistically significant(P<0.05).The comparison group after CPB by48h to1h,12h in PA-aO2significantly reduced (P<0.05). Compared with preoperation in the Oxygenation index significantly reduced (P<0.05). No significant change in the group in the Oxygenation index. Compared with preoperation in the respiratory index significantly reduced (P<0.05). No significant change in the group in the respiratory index.The Experimental Group:Compared with preoperation was no significant change in PaO2.And PA-a02were significantly lower statistically significant(P<0.05).The comparison group after CPB24h,48h to1h,12h in PA-aO2significantly reduced (P<0.05). Compared with preoperation in the Oxygenation index and the respiratory index were no significant change(P>0.05).No significant change in the group in the respiratory index and the Oxygenation index.The Two Groups Comparisons:The two groups after CPB in PaO2,comparisons changed significantly after CPBlh,12h,24h,with statistical significance (P<0.05).No significant changes after CPB48h in the two groups, capacity of Spontaneous breathing and lung function restoration to normal levels, but later than the experimental group. The two groups after CPB in PA-a02, comparisons changed significantly after CPBlh,12h,24h, with statistical significance (P<0.05).No significant changes after CPB48h in the two groups,but the recovery time of the Control group is also longer. The two groups after CPB in the Oxygenation index, comparisons changed significantly after CPBlh,12h,24h,with statistical significance (P<0.05).No significant changes after CPB48h in the two groups(P>0.05).The two groups after CPB in the respiratory index, comparisons changed significantly after CPB1h,12h,24h and48h with statistical significance (P<0.05).The respiratory index may also reflect an important indicator of lung function.Conclusion1.Continuous use of Ulinastatin can effectively improve lung function in patients during cardiopulmonary bypass and postoperative.2.Application of Heart valve replacement perioperative UTI can reduce the time of mechanical ventilation, reduce Complication rates,reduce Leave ICU and Hospitalization time; improve efficacy, reduce the general health care costs, be favorable to improve the prognosis.