低分子肝素钙治疗老年慢性阻塞性肺疾病急性加重期合并肺源性心脏病患者的临床观察

Clinical Observation of Low Molecular Weight Heparin Calcium in the Treatment of Elderly Patients with Acute Exacerbation Phase of Chronic Obstructive Pulmonary Disease Complicated with Pulmonary Heart Disease

目的:探讨低分子肝素钙治疗对老年慢性阻塞性肺疾病急性加重期(AECOPD)合并肺源性心脏病(PHD)患者血气分析指标、凝血功能及心功能的影响.方法:选取2020年3月至2022年5月本院收治的AECOPD合并PHD患者98例作为研究对象.按照治疗方式的不同,分为观察组(n=51,利伐沙班+低分子肝素钙治疗)和对照组(n=47,利伐沙班治疗).比较两组患者血气分析指标、凝血功能、心功能、不良反应.结果:治疗后观察组酸碱度(pH)、动脉血氧分压(Pa02)、凝血酶原时间(PT)、右室射血分数(RVEF)、左室射血分数(LVEF)高于对照组,差异均有统计学意义(P<0.05);观察组二氧化碳分压(PaCO_(2))、纤维蛋白原(FIB)、D-二聚体(DD)、舒张末期心室容积(EDV)、收缩末期心室容积(ESV)低于对照组,差异均有统计学意义(P<0.05).两组不良反应发生率比较,差异无统计学意义(P>0.05).结论:低分子肝素钙治疗AECOPD合并PHD患者有利于改善血气分析指标、凝血功能及心功能,安全性尚可.

Objective:To explore the effectiveness of low molecular weight heparin calcium in the treatment of elder patients with acute exacerbation phase of chronic obstructive pulmonary disease(AECOPD)complicated pulmonary heart disease(PHD).Methods:Ninety-eight patients with AECOPD and PHD treated in our hospital from March 2020 to May 2022 were selected in this research.And according to different treatment methods,they were divided into the observation group(n=51,rivaroxaban+low molecular weight heparin calcium),the control group(n=47,rivaroxaban).The blood gas analysis indexes,coagulation function,cardiac function,and incidence of adverse reactions were compared between the two groups.Results:After treatment,the pH,partial pressure of oxygen(PaO_(2)),prothrombin time(PT),right ventricular ejection fraction(RVEF)and left ventricular ejection fraction(LVEF)in the observation group were higher than those in the control group(P<0.05).The partial pressure of carbon dioxide(PaCO_(2)),fibrinogen(FIB),D-dimer(DD),end diastolic ventricular volume(EDV),and end systolic ventricular volume(ESV)in the observation group were lower than those in the control group(P<0.05).There was no statistically significant difference in incidence of adverse reactions between the two groups(P>0.05).Conclusion:Low molecular weight heparin calcium treatment is beneficial for improving blood gas analysis indicators,coagulation function,and cardiac function in AECOPD patients with PHD,with acceptable safety.