肝素雾化吸入减少脾切除术后患者肺部感染的疗效

Efficacy of heparin aerosol inhalation in patients after splenectomy

目的探讨肝素雾化吸入减少脾切除患者术后肺部感染的疗效。方法脾切除术后患者126例,术后随机选择使用肝素雾化吸入(A组,54例)或氨溴索雾化吸入(B组,72例)治疗,比较两组术后5d排痰量、血气分析、凝血指标和术后肺部感染发生率。结果 A组雾化吸入5d总排痰量多于B组[(25.66±4.83)ml vs.(17.31±3.43)ml](P<0.01);雾化吸入第5天,A组动脉血氧分压和氧合指数均高于B组[(103.6±20.6)mmHg和(555.4±59.2)mmHg vs.(95.1±17.6)mm Hg和(489.3±43.5)mm Hg](P<0.05)。A组术后肺部感染发生率低于B组[1.85%(1/54)vs.6.94%(5/72)](P<0.05)。A组部分凝血活酶时间和D-二聚体改善优于B组(P<0.05)。结论脾切除术后使用肝素雾化吸入能明显促进患者排痰,改善通气功能,降低肺部感染发生率。

Objective To investigate the efficacy of heparin aerosol inhalation in patients after splenectomy.Methods A total of 126 patients after splenectomy was randomly assigned into two groups of A（treated with heparin aerosol inhalation,54 cases）and B（treated with ambroxol hydrochloride,72 cases）.The amount of expectoration,arterial blood gas analysis,coagulation indicators and pulmonary infection rate were observed and analyzed.Results Total amount of expectoration was more in group A than that in group B[（25.66±4.83）ml vs.（17.31±3.43）ml]（P0.01）.On the 5^th day of aerosol inhalation,arterial partial pressure of oxygen and oxygenation index were higher in group A than those in group B[（103.6±20.6）mm Hg and（555.4±59.2）mm Hg vs.（95.1±17.6）mm Hg and（489.3±43.5）mm Hg]（P〈0.05）.The improvements in partial thromboplastin time and D-dimmer were better in group A than those in group B（P〈0.05）.Conclusion The heparin aerosol inhalation has the advantages of provotung expectoration,improving respiratory function and reducing incidence of pulmonary fection in the patients after splenectomy.