低分子肝素对肺源性心脏病伴呼吸衰竭患者呼吸机治疗影响研究
摘要
目的探讨低分子肝素对肺源性心脏病伴呼吸衰竭患者呼吸机治疗的影响。方法选取南京大学医学院附属鼓楼医院自2016年1月至2018年7月收治的95例肺源性心脏病伴呼吸衰竭患者为研究对象。按照随机数字表法,将患者分入A组(n=45)和B组(n=50)。A组患者接受常规处理和呼吸机治疗,B组患者在A组基础上联合低分子肝素钙进行治疗,两组均连续治疗1周。比较两组临床有效率,治疗前后的血气和炎症指标,以及不良反应发生情况。结果治疗后,B组有效率92.0%(46/50)高于A组的75.6%(34/45),差异有统计学意义(P<0.05)。治疗后,A组和B组二氧化碳分压均明显低于治疗前,且B组低于A组,差异有统计学意义(P<0.05)。治疗后,A组和B组氧分压均明显高于治疗前,且B组高于A组,差异有统计学意义(P<0.05)。A组和B组治疗前后pH值比较,差异均无统计学意义(P>0.05)。治疗后,A组和B组C反应蛋白、降钙素原、白细胞介素-6均明显低于治疗前,且B组低于A组,差异有统计学意义(P<0.05)。两组患者不良反应发生率比较,差异无统计学意义(P>0.05)。结论低分子肝素对肺源性心脏病伴呼吸衰竭患者呼吸机治疗有积极影响,可改善患者血气和炎症指标,且安全性好。
引文
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[3] Annane D,Pastores SM,Rochwerg B,et al.Guidelines for the diagnosis and management of Critical Illness-Related Corticosteroid Insufficiency (CIRCI) in critically ill patients (Part Ⅰ):Society of Critical Care Medicine (SCCM) and European Society of Intensive Care Medicine (ESICM) 2017[J].Crit Care Med,2017,45(12):2078-2088.
[4] 曾建红,曾军,李越利,等.低分子肝素在慢性阻塞性肺疾病急性加重期合并呼吸衰竭的治疗作用[J].中国医药科学,2016,6(14):46-48,51.
[5] 叶任高.内科学[M].5版.北京:人民卫生出版社,2000:46-55.
[6] Tomioka T,Fukui K,Tanaka S,et al.Influence of atrial fibrillation on cardiac prognosis in chronic obstructive pulmonary disease[J].Indian Heart J,2019,71(1):7-11.
[7] Tomioka T,Fukui K,Tanaka S,et al.Influence of atrial fibrillation on cardiac prognosis in chronic obstructive pulmonary disease[J].Indian Heart J,2019,71(1):7-11.
[8] Alrddadi SM,Morsy MM,Albakri JK,et al.Risk factors for prolonged mechanical ventilation after surgical repair of congenital heart disease.Experience from a single cardiac center[J].Saudi Med J,2019,40(4):367-371.
[9] 高莉芳,吕雁,窦体敏.肺源性心脏病并发Ⅱ型呼吸衰竭治疗中无创呼吸机的应用价值探析[J].基层医学论坛,2017,21(34):4805-4806.
[10] 王秋婷,何海武,石慧芳,等.老年呼吸衰竭伴慢性肺源性心脏病患者血浆血小板活化因子及血小板功能的变化[J].山东医药,2017,57(25):83-84.
[11] Shimoda LA.Overview:pulmonary vascular function in health and disease[J].J Physiol,2019,597(4):973-974.
[12] 李德铭,陈耀洪,陈洁兰.低分子肝素联合无创通气对肺源性心脏病急性加重期患者的疗效观察[J].中国实用医药,2017,12(11):120-121.
[13] Arslan S,Yildiz G,?zdemir L,et al.Association between blood pressure,inflammation and spirometry parameters in chronic obstructive pulmonary disease[J].Korean J Intern Med,2019,34(1):108-115.
[14] 汪江,杨亚东,佘秋芳,等.序惯辅助控制通气对慢性肺源性心脏病合并呼吸衰竭患者心肺功能及全身炎症状态的影响[J].海南医学院学报,2018,24(8):825-828.
[15] 刘晋仙,李玮涛,张在忠,等.低分子肝素药理学机制及适应证研究进展[J].药学研究,2015,34(7):420-421,424.