中国医药
中國醫藥
중국의약
CHINA MEDICINE
2011年
1期
89-91
,共3页
吴贺文%叶培军%黄静%冯艳平
吳賀文%葉培軍%黃靜%馮豔平
오하문%협배군%황정%풍염평
脓毒症%普通肝素%治疗
膿毒癥%普通肝素%治療
농독증%보통간소%치료
Sepsis%Unfractionated heparin%Therapy
目的 探讨小剂量普通肝素对脓毒症的治疗作用.方法 将2007年10月至2009年12月入住我院ICU的85例脓毒症患者分为普通肝素治疗组45例和对照组40例.对照组给予早期应用广谱抗生素和容量复苏、控制血糖、抑酸保护胃黏膜、纠正水、电解质和酸碱平衡紊乱、脏器支持、基础病因治疗、营养支持及对症治疗.普通肝素治疗组在进行上述治疗的同时加用普通肝素5 U/(kg·h),24 h持续静脉泵入,疗程为1周(或用至患者出现低凝状态或出血倾向,或用至患者出院或死亡).比较2组患者治疗前后APACHEⅡ评分、CRP、凝血指标及血小板计数的变化;比较2组7 d及28 d转归及2组出血并发症发生率.结果 普通肝素治疗组28 d生存率为82.22%(37/45),对照组为62.50%(25/40),2组间差异有统计学意义(P＜0.05).治疗后1周APACHEⅡ评分2组差异无统计学意义(P＞0.05),但可以看出普通肝素治疗组的评分较对照组改善更大;普通肝素治疗组治疗前后比较,差异具有统计学意义(P＜0.05);治疗后1周2组CRP差异无统计学意义(P＞0.05),但2组治疗前后组内比较差异均有统计学意义(P＜0.01或P＜0.05).2组治疗前后凝血功能的指标及血小板计数均差异无统计学意义(P＞0.05);与对照组相比普通肝素治疗组未增加出血并发症的发生率.结论 小剂量普通肝素治疗能显著改善脓毒症患者的生存率,且无严重并发症,临床应用安全.
目的 探討小劑量普通肝素對膿毒癥的治療作用.方法 將2007年10月至2009年12月入住我院ICU的85例膿毒癥患者分為普通肝素治療組45例和對照組40例.對照組給予早期應用廣譜抗生素和容量複囌、控製血糖、抑痠保護胃黏膜、糾正水、電解質和痠堿平衡紊亂、髒器支持、基礎病因治療、營養支持及對癥治療.普通肝素治療組在進行上述治療的同時加用普通肝素5 U/(kg·h),24 h持續靜脈泵入,療程為1週(或用至患者齣現低凝狀態或齣血傾嚮,或用至患者齣院或死亡).比較2組患者治療前後APACHEⅡ評分、CRP、凝血指標及血小闆計數的變化;比較2組7 d及28 d轉歸及2組齣血併髮癥髮生率.結果 普通肝素治療組28 d生存率為82.22%(37/45),對照組為62.50%(25/40),2組間差異有統計學意義(P＜0.05).治療後1週APACHEⅡ評分2組差異無統計學意義(P＞0.05),但可以看齣普通肝素治療組的評分較對照組改善更大;普通肝素治療組治療前後比較,差異具有統計學意義(P＜0.05);治療後1週2組CRP差異無統計學意義(P＞0.05),但2組治療前後組內比較差異均有統計學意義(P＜0.01或P＜0.05).2組治療前後凝血功能的指標及血小闆計數均差異無統計學意義(P＞0.05);與對照組相比普通肝素治療組未增加齣血併髮癥的髮生率.結論 小劑量普通肝素治療能顯著改善膿毒癥患者的生存率,且無嚴重併髮癥,臨床應用安全.
목적 탐토소제량보통간소대농독증적치료작용.방법 장2007년10월지2009년12월입주아원ICU적85례농독증환자분위보통간소치료조45례화대조조40례.대조조급여조기응용엄보항생소화용량복소、공제혈당、억산보호위점막、규정수、전해질화산감평형문란、장기지지、기출병인치료、영양지지급대증치료.보통간소치료조재진행상술치료적동시가용보통간소5 U/(kg·h),24 h지속정맥빙입,료정위1주(혹용지환자출현저응상태혹출혈경향,혹용지환자출원혹사망).비교2조환자치료전후APACHEⅡ평분、CRP、응혈지표급혈소판계수적변화;비교2조7 d급28 d전귀급2조출혈병발증발생솔.결과 보통간소치료조28 d생존솔위82.22%(37/45),대조조위62.50%(25/40),2조간차이유통계학의의(P＜0.05).치료후1주APACHEⅡ평분2조차이무통계학의의(P＞0.05),단가이간출보통간소치료조적평분교대조조개선경대;보통간소치료조치료전후비교,차이구유통계학의의(P＜0.05);치료후1주2조CRP차이무통계학의의(P＞0.05),단2조치료전후조내비교차이균유통계학의의(P＜0.01혹P＜0.05).2조치료전후응혈공능적지표급혈소판계수균차이무통계학의의(P＞0.05);여대조조상비보통간소치료조미증가출혈병발증적발생솔.결론 소제량보통간소치료능현저개선농독증환자적생존솔,차무엄중병발증,림상응용안전.
Objective To explore the therapeutic effects of low-dose unfractionated heparin(UFH) therapy on sepsis. Methods Eighty-five sepsis patients were divided into two groups: heparin treatment group ( n = 45 )and routine treatment group (control group) (n =40). The patients of control group received a series of remedies,including broad-spectrum antibiotics in early stage, supplementing of circulation volume, protecting of mucosal membrane of stomach, correcting the water, electrolyte and acid-base disturbance, and nutrition and supportive therapy. The patients of UFH treatment group were treated with UFH 5 U/( kg · h) by continuous intravenous infusion for 7 days in addition to routine treatment. The difference of APACHE-Ⅱ score, CRP, coagulation markers and platelet count between two groups were analyzed before and after treatment. The hemorrhage complication and survival rate in 7 days and 28 days were compared between the two groups. Results The survival rate was 82.22％ and 62.50％ in UFH treatment group and control group respectively (P ＜ 0.05). There was no significant difference of coagulation markers and PLT count between the two groups before and after treatment (P ＞ 0. 05). The incidence of hemorrhage complication was not higher in UFH treatment group compared with that of control group (P ＞ 0.05 ).Conclusion UFH therapy can improve the survival rate of patients with sepsis.
