Abstract: Objective　To investigate the hemodynamic effects of ulinastatin on neonatal necrotizing enterocolitis（NEC） and the effectiveness of clinical treatment. Methods　A reprospective study was adopted. A total of 150 cases of neonatal necrotizing enterocolitis were chosen，who were clinically diagnosed in Xi 'an Children's Hospital from August 2016 to January 2020. 30 cases in the observation group were treated with ulinastatin，and the other 120 cases without ulinastatin were used as the control group. Demographic baseline data of the two groups were collected，the changes in clinical biochemical indexes before and 48 h after treatment were compared between the two groups. The changes in hemodynamic indexes in the observation group at different time points of ulinastatin injection were continuously measured. At the same time，compare the hemodynamic changes at 24h and 48h after medication between the two groups，and compare the difference in hospitalization as well. Results　After 48 hours of treatment，the levels of prothrombin time（PT），partial thrombin time（APTT），D-dimer（D-D），serum creatinine（Scr），serum lactate（Lac），serum precalcitonin（PCT），interleukin-6 （IL-6）and interleukin-8 （IL-8） were all lower than those before treatment，in the observation group（all P<0.05） while APTT，D-dimer，PCT，IL-6 and I L-8 in the control group were higher than those before treatment（all P<0.05）. The PT，APTT，D-dimer，Scr，Lac，PCT，IL-6，IL-8 in the observation group were lower than those in the control group at 48 hours after treatment. After 48 h of treatment，the incidence of blood stool，abdom-inal distension，bowel sound attenuation，abdominal ultrasound and abdominal tablet abnormality in the observation group was all lower than that before treatment and in the control group （all P<0.05）. In the observation group，after 30 minutes in ulinastatin，the changes of hemodynamic indexes were not significant. After 60 minutes of medication，hemodynamics tended to improve and gradually remained stable .The difference in continuous measurement within the group was statistically significant（all P<0.05）. Compared with the control group，the fasting time，length of hospital stay，incidence of surgical operation and mortality were all decreased in the observation group （all P<0.05）. Conclusion　Ulinastatin can improve hemodynamics by reducing the inflammatory response of the body，and reduce the fasting time，hospitalization time，incidence of surgery and mortality of neonatal necrotizing enterocolitis.

Key words: ulinastatin, neonate, necrotizing enterocolitis, hemodynamics

摘要： 目的　探讨乌司他丁对Ⅰ～Ⅱ级新生儿坏死性小肠结肠炎血流动力学的影响及临床治疗的有效性。方法　采用回顾性研究方法，选择西安市儿童医院2016年8月至2020年1月临床诊断Ⅰ～Ⅱ级新生儿坏死性小肠结肠炎患儿150例，30例应用乌司他丁的患儿设为观察组、其他120例患儿为对照组；统计两组患儿的人口学基线资料，比较两组临床生化指标在治疗前以及治疗48 h后的差异，连续性测量观察组应用乌司他丁不同时间节点血流动力学指标的变化，同时比较两组患儿在用药24 h及48 h血流动力学指标变化的组间差异；比较两组之间住院情况的差异。结果　两组患儿在治疗48 h后观察组在凝血酶原时间（PT）、部分凝血活酶时间（APTT）、D-二聚体（D-D）、血清肌酐（Scr）、血清乳酸（Lac）、血清前降钙素原（PCT）、白细胞介素（IL）-6和IL-8等较治疗前降低（P<0.05），而对照组APTT、D-D、PCT、IL-6、IL-8等较治疗前升高（P<0.05）；观察组治疗48 h后在PT、APTT、D-D、Scr、Lac、PCT、IL-6、IL-8等均低于对照组，观察组治疗48 h后血便、腹胀、肠鸣音减弱、腹部超声及腹片异常发生率均较治疗前及对照组降低（P<0.05）；观察组在应用乌司他丁30 min后，血流动力学指标变化不显著，用药60 min后血流动力学指标趋于好转并逐渐保持稳定，组内连续测量差异具有统计学意义（P<0.05）；与对照组比较观察组在禁食时间、住院时间、外科手术率及病死率等均降低（P<0.05）。结论　乌司他丁通过降低机体的炎症反应，达到改善血流动力学，降低新生儿坏死性小肠结肠炎、患儿禁食时间、住院时间、外科手术发生率及病死率的临床效果。

关键词: 乌司他丁, 新生儿, 坏死性小肠结肠炎, 血流动力学