综合干预对慢性阻塞性肺疾病急性加重期患者静脉血栓栓塞的预防价值

Preventive value of comprehensive intervention on venous thromboembolism in patient with acute exacerbation of chronic obstructive pulmonary disease

目的探讨综合干预对慢性阻塞性肺疾病急性加重期(AECOPD)患者静脉血栓栓塞(VTE)的预防价值。方法收集2019年6月至2023年2月于海安市人民医院接受诊治的128例AECOPD患者的临床资料,根据是否接受了综合干预将患者分为干预组(n=61)和对照组(n=67)。比较两组患者AECOPD专科信息,包括病程、是否存在肺动脉高压、是否发生呼吸衰竭、入院时动脉血气分析结果[酸碱值(pH)、动脉血氧分压(PaO_(2))、动脉血二氧化碳分压(PaCO_(2))、实际碳酸氢根离子(HCO_(3)^(-))、氧饱和度、住院期间进行机械通气的比例]、凝血功能、VTE发生情况、并发症发生情况。结果两组患者的病程、是否存在肺动脉高压、是否发生呼吸衰竭、入院时pH值、PaO_(2)、PaCO_(2)、实际HCO_(3)^(-)、氧饱和度及住院期间进行机械通气的比例比较,差异均无统计学意义(P>0.05)。干预组患者住院期间VTE的发生率低于对照组患者,差异有统计学意义(P<0.05)。两组患者住院期间其他并发症的发生率比较,差异无统计学意义(P>0.05)。经组内和组间比较,两组患者入院时和出院前的凝血酶原时间、活化部分凝血活酶时间比较,差异均无统计学意义(P>0.05)。结论综合干预可明显降低AECOPD患者VTE的发生风险,值得临床推广并深入研究。

Objective To explore the value of comprehensive intervention in preventing venous thromboembolism(VTE)of patient with acute exacerbation of chronic obstructive pulmonary disease(AECOPD).Method Clinical data of 128 patients with AECOPD who were diagnosed and treated in the Haian People's Hospital from June 2019 to February 2023 were collected and divided into the intervention group(n=61)and the control group(n=67)according to whether they received comprehensive intervention.The AECOPD specialized information(course of disease,presence of pulmonary hypertension,occurrence of respiratory failure,results of arterial blood gas analysis at admission[pondus hydrogenii(pH),partial pressure of oxygen in arterial blood(PaO_(2)),partial pressure of carbon dioxide in arterial blood(PaCO_(2)),actual HCO_(3)^(-),oxygen saturation,and the proportion of mechanical ventilation],coagulation function,incidence of VTE,incidence of complications during hospitalization were compared.Result There were no significant differences in the course of disease,pulmonary hypertension,respiratory failure,pH value at admission,PaO_(2),PaCO_(2),actual HCO_(3)^(-),oxygen saturation and the proportion of mechanical ventilation during hospitalization between the two groups(P>0.05).The incidence rate of VTE in the intervention group was lower than that in the control group(P<0.05).There were no significant differences in the incidence rate of other complications during hospitalization between the two groups(P>0.05).There was no significant difference in prothrombin time and activated partial thromboplastin time between and within the two groups at admission and before discharge(P>0.05).Conclusion Comprehensive intervention can significantly reduce the risk of VTE in AECOPD patients,which is worthy of promotion in clinical practice and further in-depth research.