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目的探讨低分子肝素钙皮下注射治疗慢性阻塞性肺疾病并肺心病急性加重期的临床疗效及安全性。方法选取2013年10月—2015年10月宁夏医科大学附属医院石嘴山市第二人民医院收治的慢性阻塞性肺疾病并肺心病急性加重期患者108例,按照随机数字表法将患者分为对照组与观察组,各54例。对照组给予常规治疗,观察组在常规治疗的基础上给予皮下注射低分子肝素钙治疗,比较两组患者临床疗效及治疗前后血气分析指标[p H值、氧分压(PaO_2)、二氧化碳分压(PaCO_2)]、肺功能[用力肺活量占预计值的百分比(FVC%)、第1秒用力呼气容积占预计值的百分比(FEV_1%)、FEV_1/用力肺活量(FVC)]、血凝及纤溶[凝血酶原时间(PT)、血小板计数(PLT)、凝血酶时间(TT)、纤维蛋白原(FIB)]指标改善情况及药物不良反应发生情况。结果观察组患者总有效率高于对照组,差异有统计学意义(P<0.05)。治疗前两组患者血气分析指标比较,差异无统计学意义(P>0.05);治疗后观察组患者p H值、PaO_2高于对照组,PaCO_2低于对照组,差异有统计学意义(P<0.05)。治疗前两组患者PT、TT、FIB及PLT比较,差异无统计学意义(P>0.05);治疗后观察组患者PT、TT高于对照组,FIB低于对照组,差异有统计学意义(P<0.05)。治疗前两组患者肺功能指标比较,差异无统计学意义(P>0.05);治疗后观察组患者FVC%、FEV_1/FVC及FEV_1%高于对照组,差异有统计学意义(P<0.05)。治疗过程中两组患者均未出现严重不良反应。结论低分子肝素钙皮下注射治疗慢性阻塞性肺疾病并肺心病急性加重期临床效果确切,可有效改善患者血气分析指标、肺功能,且不良反应少。
Objective To investigate the clinical efficacy and safety of subcutaneous injection of low molecular weight heparin in the treatment of chronic obstructive pulmonary disease (COPD) with acute exacerbation of pulmonary heart disease. Methods From October 2013 to October 2015, 108 patients with chronic obstructive pulmonary disease and acute exacerbation of pulmonary heart disease were admitted to the Second People’s Hospital of Shizuishan, Affiliated Hospital of Ningxia Medical University. Patients were divided into control group And observation group, each 54 cases. The control group was given conventional treatment. The observation group was given subcutaneous injection of low molecular weight heparin calcium on the basis of conventional treatment. The clinical curative effect and blood gas analysis index [p H value, PaO 2, (PaCO 2)], pulmonary function [FVC% of forced vital capacity, FEV 1% of FEV 1, FEV 1 / FVC], hemagglutination and fibrosis [Prothrombin time (PT), platelet count (PLT), thrombin time (TT), fibrinogen (FIB)] indicators to improve the situation and adverse drug reactions. Results The total effective rate of observation group was higher than that of control group, the difference was statistically significant (P <0.05). Before treatment, there was no significant difference in blood gas analysis index between the two groups (P> 0.05). After treatment, p H value in the observation group was higher than that in the control group and PaCO 2 was lower in the observation group than in the control group (P < 0.05). There was no significant difference in PT, TT, FIB and PLT between the two groups before treatment (P> 0.05). After treatment, the PT and TT in the observation group were higher than those in the control group, but the FIB was lower than the control group P <0.05). Before treatment, there was no significant difference in lung function between the two groups (P> 0.05). After treatment, FVC%, FEV_1 / FVC and FEV_1% in the observation group were significantly higher than those in the control group (P <0.05) . No serious adverse reactions occurred in both groups during the course of treatment. Conclusion Low molecular weight heparin subcutaneous injection of chronic obstructive pulmonary disease and acute exacerbation of pulmonary heart disease clinical effect is exact, can effectively improve the patient’s blood gas analysis indicators, pulmonary function, and less adverse reactions.