低分子肝素钠治疗慢性阻塞性肺疾病急性加重期的效果分析

Effect of low molecular weight heparin on acute exacerbation of chronic obstructive pulmonary disease

目的探究低分子肝素钠治疗慢性阻塞性肺疾病急性加重期的临床效果。方法随机选取该院呼吸内科2014年11月‐2015年11月收治的慢性阻塞性肺疾病急性加重期患者200例,运用数字随机法将其分为对照组和观察组,对照组患者给予常规治疗,观察组患者在常规治疗基础上加用低分子肝素钠5 000 IU皮下注射,分析两组患者的治疗效果。结果观察组患者治疗总有效率为96%(96/100),显著高于对照组患者的65%(65/100)(P<0.05);观察组患者治疗后二氧化碳分压(PaCO_2)明显低于治疗前(P<0.05);观察组患者治疗后氧分压(PaO_2)和血氧饱和度(SpO_2)明显高于治疗前(P<0.05);观察组患者治疗前后p H值比较差异无统计学意义(P>0.05);对照组患者治疗前后PaCO_2、PaO_2、SpO_2和p H值比较差异均无统计学意义(P>0.05);观察组患者治疗后活化部分凝血酶原时间(APTT)、纤维蛋白原(FIB)、全血还原比黏度、全血比黏度和红细胞比容均显著低于治疗前(P<0.05);观察者患者血浆比黏度显著高于治疗前(P<0.05);对照组患者治疗前后APTT、FIB、全血还原比黏度、全血比黏度、红细胞比容和血浆比黏度比较差异均无统计学意义(P>0.05);观察组患者治疗后1秒用力呼气量占预计值比值(FEV1/预计值)、1秒用力呼气量占用力肺活量比值(FEV1/FVC)和6 min步行距离(6-MWD)均显著高于治疗前(P<0.05);对照组患者治疗前后FEV1/预计值、FEV1/FVC和6-MWD比较差异均无统计学意义(P>0.05)。结论低分子肝素钠治疗慢性阻塞性肺疾病急性加重期与常规治疗相比效果显著,可有效改善患者血液循环和肺循环,提高肺功能,值得临床上进一步推广应用。

[Objective]To explore the efficacy of low molecular weight heparin in the treatment of acute exacerbation of chronic obstructive pulmonary disease.[Methods]A total of 200 patients during the period of acute exacerbation of chronic obstructive pulmonary disease admitted in the respiratory department of our hospital from November 2014 to November 2015 were randomly selected,and were divided into control group and observation group using random number table.The control group were treated with routine treatment,while the observation group were given subcutaneous injection of low molecular weight heparin sodium 5000 IU on the basis of conventional treatment.The therapeutic effects of two groups of patients were analyzed.[Results]The total efficiency of the observation group was significantly higher than that of the control group（P〈0.05）;in the observation group after treatment,partial pressure of carbon dioxide（PaCO2） was significantly lower than that before treatment（P〈0.05）,partial pressure of oxygen（PaO2） and pulse oxygen saturation（SpO2） were significantly higher than those before treatment（P〈0.05）,no significant differences in pH were found in the observation group before and after the treatment（P〉0.05）;in the control group,there were no significant differences in PaCO2,PaO2,SpO2 and pH before and after treatment（P〉0.05）;in the observation group after treatment,activated partial thromboplastin time（APTT）,fibrinogen（FIB）,total blood reduction specific viscosity,whole blood viscosity and hematocrit were significantly lower than those before treatment（P〈0.05）;after treatment,the plasma specific viscosity in the observation group was significantly higher than before treatment（P〈0.05）;there was no significant difference in APTT,FIB,whole blood reduction specific viscosity,whole blood viscosity,hematocrit and plasma specific viscosity before and after treatment in the control group（P〈0.05）;in the observation group after treatment,the ratio of forced expiratory volume in one second to predicted value（FEVl%pred）,the ratio of forced expiratory volume in one second to forced vital capacity（FEV1/FVC） and 6-minute walking distance（6-MWD） were significantly higher than those before treatment（P〈0.05）;in the control group,there was no significant difference in FEVl%pred,FEV1/FVC and 6-MWD before and after treatment（P〈0.05）.[Conclusion]When compared with conventional treatment,the effect of low molecular heparin sodium in treatment for acute exacerbation of chronic obstructive pulmonary disease is remarkable,which can effectively improve the patient＇s blood circulation and pulmonary circulation,improve lung function and is worth for further clinical promotion and application.