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目的研究低分子肝素钙对肺源性心脏病急性发作并呼吸衰竭的疗效。方法对39例肺心病急性发作并呼吸衰竭患者按随机双盲法分为观察组A20例,对照组B19例,A、B两组的常规治疗如抗感染、氧疗、改善通气、强心、利尿等相同,仅观察组A用低分子肝素钙5000IU于腹壁皮下注射2次/d,10d为1个疗程,监测A、B两组治疗前后血气pH、PaO2、PaCO2,全血高切黏度、红细胞比容及纤维蛋白原,并观察A、B两组临床疗效(水肿、紫绀、哮喘,心率及肺部啰音的变化)及病死率。结果治疗后A组较B组心肺功能明显改善,红细胞比容和全血高切黏度明显降低,PaCO2降低,PaO2明显增高,A组临床总有效率高于B组,A组病死率低于B组。结论低分子肝素钙皮下注射可改善肺心病急性发作并呼吸衰竭患者的心肺功能、血液性状及通气,且能提高临床总有效率,降低病死率。
Objective To study the effect of low molecular weight heparin on acute attack of pulmonary heart disease and respiratory failure. Methods Thirty-nine patients with acute episode of pulmonary heart disease and respiratory failure were randomly divided into observation group (A20) and control group (B19). Patients in groups A and B received routine treatment such as anti-infection, oxygen therapy, Diuretic and the same, only observation group A low molecular weight heparin 5000IU in the abdominal subcutaneous injection 2 times / d, 10d for a course of treatment, monitoring A, B two groups before and after treatment of blood gas pH, PaO2, PaCO2, whole blood high shear viscosity, Hematocrit and fibrinogen, and observed the clinical efficacy (edema, cyanosis, asthma, heart rate and pulmonary rales) and mortality in groups A and B. Results After treatment, the cardiopulmonary function of group A was significantly improved, the hematocrit and whole blood high shear viscosity were significantly decreased, PaCO2 was decreased, PaO2 was significantly increased, the total effective rate of group A was higher than that of group B, and the mortality of group A was lower than that of group B group. Conclusion Subcutaneous injection of low molecular weight heparin can improve cardiopulmonary function, blood traits and ventilation in patients with acute pulmonary heart disease and respiratory failure, and can improve the total effective rate and reduce the mortality rate.