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目的观察低分子肝素钠治疗急性缺血性结肠炎的临床疗效及安全性。方法选取2009年1月至2013年1月在蕲春县人民医院确诊的急性缺血性结肠炎患者60例,按就诊顺序随机分为研究组与对照组,每组各30例,对照组给予基础治疗,研究组在基础治疗的基础上加用低分子肝素钠治疗,两组疗程均为2周。记录两组治疗3 d及治疗7 d腹痛、便血缓解的例数;观察研究组治疗前、后凝血酶原时间(PT)、活化部分凝血酶原时间(APTT)、血小板计数变化;所有患者2周后均复查结肠镜。结果研究组与对照组比较,治愈率、治疗3 d及治疗7 d腹痛、便血缓解例数比较差异均有统计学意义(P<0.05);总有效率研究组高于对照组,但差异无统计学意义(P>0.05);研究组治疗前后PT、APTT、血小板计数变化差异无统计学意义(P>0.05);治疗组中,有4例低分子肝素钠注射部位出现直径0.5~1.0 cm皮肤瘀斑,其余病例无意外出血事件发生。结论低分子肝素钠治疗急性缺血性结肠炎有利于早期缓解腹痛、便血症状,明显提高治愈率,且出血风险小。
Objective To observe the clinical efficacy and safety of low molecular weight heparin in the treatment of acute ischemic colitis. Methods Sixty patients with acute ischemic colitis diagnosed in Renchuan County People’s Hospital from January 2009 to January 2013 were randomly divided into study group and control group according to the order of treatment, 30 cases in each group and 30 cases in control group The basis of treatment, the study group based on the basic treatment plus low molecular weight heparin treatment, two courses were 2 weeks. The number of cases of abdominal pain and blood in the stool of the two groups were recorded at 3 days and 7 days after treatment. Prothrombin time (PT), APTT and platelet count were observed before and after treatment in all groups. All patients 2 Week after review of colonoscopy. Results Compared with the control group, there were significant differences in the cure rate, the number of abdominal pain and blood in the stool after 3 days of treatment and on the 7th day of treatment (P <0.05), while the total effective rate was higher in the study group than in the control group (P> 0.05). There was no significant difference in PT, APTT and platelet count before and after treatment in study group (P> 0.05). In the treatment group, there were 4 cases with low molecular weight heparin sodium injection with diameter of 0.5-1.0 cm Skin ecchymosis, the remaining cases no accidental bleeding occurred. Conclusion Low molecular weight heparin treatment of acute ischemic colitis is conducive to early relief of abdominal pain, blood stool symptoms, significantly improve the cure rate, and the risk of bleeding is small.