早期应用低分子肝素治疗老年严重脓毒症的临床效果

Early application of low molecular heparin in treatment of senile severe sepsis

目的观察早期应用低分子肝素辅助治疗老年严重脓毒症的效果及机制。方法选取符合诊断标准的32例老年严重脓毒症患者随机分为试验组和对照组,对照组患者给予常规治疗,试验组在常规治疗基础上给予低分子肝素,观察两组治疗前后急性生理学慢性健康状况Ⅱ(APACHEⅡ)评分、器官功能衰竭评分(SOFA)评分、多器官功能障碍综合征(MODS)发生率、住院28天病死率、血凝血酶原时间(PT)、D-二聚体、纤维蛋白原(FIB)、血小板(PLT)等凝血功能指标及血清白细胞介素6(IL-6)、肿瘤坏死因子α(TNF-α)水平。结果治疗后试验组APACHEⅡ评分、SOFA评分、血清IL-6水平明显低于对照组。结论早期应用低分子肝素可通过改善凝血功能、降低炎症反应,改善老年严重脓毒症患者的预后。

Objective To observe the effect and mechanism of early application of low molecular heparin in treatment of senile severe sepsis.Methods Thirty-two cases of elderly patients with severe sepsis were randomly divided into experimental group and control group,control group given conventional treatment,treatment group on the basis of conventional treatment to low molecular heparin.Before and after treatment,APACHE Ⅱscore,SOFA score and the incidence of MODS,28 days in hospital mortality and plasma thromboplastin,D-dimer,blood fibrinogen(FIB),platelets and coagulation function index and serum levels of interleukin-6(IL-6),tumor necrosis factor alpha were observed in two groups.Results After treatment,the APACHE grade and SOFA and the serum level of IL-6 in treatment group were significantly lower than those in control group.Conclusion Early application of low molecular heparin can improve the prognosis of elderly patients with severe sepsis by improving coagulation function and reducing inflammatory response.