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目的探讨持续小剂量肝素治疗急性呼吸窘迫综合征(ARDS)患者的临床疗效。方法 86例ARDS患者,随机分为肝素组(46例)和对照组(40例)。对照组给予常规治疗,肝素组在常规治疗的基础上加用小剂量肝素持续泵入,测定两组间患者治疗前及治疗7 d后急性生理和慢性健康状况Ⅱ评分(APACHEⅡ)、氧合指数、呼吸频率(R)、凝血酶原时间(PT)、部分活化凝血酶原时间(APTT)、血小板(PLT)、纤维蛋白原(Fbg)变化;观察两组患者平均机械通气时间、平均重症加强护理病房(ICU)住院时间及7 d病死率。结果与对照组相比,治疗7 d后肝素组APACHEⅡ评分、氧合指数(Pa O2/Fi O2)明显升高,R明显下降(P<0.05),PT、APTT、PLT、Fbg含量无明显变化(P>0.05);与对照组相比,肝素组平均机械通气时间及平均ICU住院时间均要更低,且7 d后的病死率下降明显(P<0.05)。结论对急性呼吸窘迫综合征患者实施持续小剂量肝素治疗,可以有效提高患者的临床效果,缩短患者的机械通气时间、ICU住院时间,以此减轻患者的病症痛苦,临床应用安全。
Objective To investigate the clinical efficacy of continuous low-dose heparin in the treatment of patients with acute respiratory distress syndrome (ARDS). Methods A total of 86 patients with ARDS were randomly divided into heparin group (46 cases) and control group (40 cases). The control group was given conventional treatment. The heparin group was continuously pumped with low dose heparin on the basis of conventional treatment. The APACHE Ⅱ, the oxygenation index , Respiratory rate (R), prothrombin time (PT), partial activated prothrombin time (APTT), platelet (PLT) and fibrinogen (Fbg). The mean mechanical ventilation time Nursing wards (ICU) length of stay and 7-day mortality. Results Compared with the control group, the APACHEⅡscore and the PaO2 / Fi O2 in the heparin group were significantly increased (P <0.05), while the contents of PT, APTT, PLT and Fbg in the heparin group were not significantly changed (P> 0.05). Compared with the control group, the mean duration of mechanical ventilation and ICU stay in the heparin group was lower, and the mortality after 7 days decreased significantly (P <0.05). Conclusions Continuous low-dose heparin therapy for patients with acute respiratory distress syndrome can effectively improve the clinical effect, shorten the duration of mechanical ventilation and ICU stay, so as to relieve the patient’s illness and safety of clinical application.