低分子肝素治疗对老年重症肺炎患者动脉血气及近期预后的影响

Influence of low molecular heparin on arterial blood gas and prognosis in the treatment of elderly patients with severe pneumonia

目的 探讨低分子肝素治疗对老年重症肺炎患者动脉血气及近期预后的影响。方法 选取2012年1月~2014年1月我院收集的老年重症肺炎患者64例,将其随机分为观察组与对照组,每组32例。给予对照组患者常规性治疗,给予观察组患者常规治疗的基础上,加给予低分子肝素进行治疗。在治疗后1d、3 d与7 d,观察并比较两组患者APACHEⅡ评分及动脉血PH、氧分压（PaO_2）、二氧化碳分压（Pa CO_2）、乳酸（Lac）等。结果 治疗前,两组患者APACHEⅡ评分差异无统计学意义（P〉0.05）。治疗后第1d与第3d,在APACHEⅡ评分方面,两组患者之间进行比较差异无统计学意义（P〉0.05）,在治疗后第7d,与对照组比较,观察组患者APACHEⅡ评分显著降低,两组间差异有统计学意义（P〈0.05）。治疗后第1d、3d与7d,在PH、PaCO_2及Lac方面,两组患者之间进行比较差异无统计学意义（P〉0.05）;治疗后第1d与第3d,在PaO_2方面,两组患者之间进行比较差异无统计学意义（P〉0.05）,但是在治疗后第7d,与对照组比较,观察组患者动脉血Pa O_2显著升高,两组间差异有统计学意义（P〈0.05）。结论 低分子肝素治疗老年重症肺炎能够明显改善患者的氧合,降低APACHEⅡ评分,有利于改善患者近期预后。

Objective To explore the influence of low molecular heparin on arterial blood gas and prognosis in the treatment of elderly patients with severe pneumonia. Methods 64 elderly patients with severe pneumonia were randomly divided into the observation group and the control group. The control group was given conventional treat- ment, and the observation group was given low molecular heparin additionally. 1, 3 and 7 days after the treatment, the score of APACHE 1I and the levels of PH, oxygen partial pressure, CO2 partial pressure and lactic acid in arteri- al blood were analyzed. Results Before the treatment, there was no significant difference in APACHE 1I between the two groups （P 〉 0. 05 ）. 1 and 3 days after the treatment, there was still no significant difference in APACHE H score between the two groups （P 〉 0. 05）. 7 days after the treatment, the score of APACHE lI in the observation group reduced more obviously （P 〈 0. 05）. 1,3 and 7 days after the treatment, there was no significant difference in PH, CO2 partial pressure and lactic acid in arterial blood between the two groups （P 〉 0. 05）. 1 and 3 days after the treatment, there was no significant difference in oxygen partial pressure between the two groups （ P 〉 0. 05 ）, but it showed statistically significant difference between the two groups 7 days after the treatment （P 〈 0. 05 ）. Conclusion Low molecular heparin can improve their oxygenation indexes and short-term prognosis in the treatment of elderly patients with severe pneumonia.