中国实用医药
中國實用醫藥
중국실용의약
CHINA PRACTICAL MEDICAL
2015年
18期
16-17
,共2页
重症肺炎%肝素
重癥肺炎%肝素
중증폐염%간소
Severe pneumonia%Heparin
目的：探讨联合小剂量肝素治疗重症肺炎的安全性及有效性。方法32例诊断明确、没有肝素使用禁忌证的重症肺炎患者采用随机对照分组的办法分为治疗组及对照组，各16例。治疗组同时应用200 U/(kg·d)普通肝素分次皮下或静脉给药、连续使用7 d ；对照组给予安慰剂处理。监测两组患者治疗前后的急性生理与慢性健康评分(APACHE Ⅱ评分)、氧合指数、血小板计数、活化部分凝血活酶时间(APTT)、纤维蛋白原(FBG)、白细胞计数(WBC)、C 反应蛋白(CRP)等指标；并观察总住院时间、ICU 住院时间等。结果治疗1周后治疗组氧合指数较对照组有明显改善， CRP 水平则较对照组有明显下降，差异有统计学意义(P 均<0.01)；APACH Ⅱ评分较对照组降低，差异有统计学意义(P<0.05)。结论联合小剂量肝素治疗可明显改善重症肺炎患者氧合及降低炎症介质的水平，降低 APACHE Ⅱ评分。
目的：探討聯閤小劑量肝素治療重癥肺炎的安全性及有效性。方法32例診斷明確、沒有肝素使用禁忌證的重癥肺炎患者採用隨機對照分組的辦法分為治療組及對照組，各16例。治療組同時應用200 U/(kg·d)普通肝素分次皮下或靜脈給藥、連續使用7 d ；對照組給予安慰劑處理。鑑測兩組患者治療前後的急性生理與慢性健康評分(APACHE Ⅱ評分)、氧閤指數、血小闆計數、活化部分凝血活酶時間(APTT)、纖維蛋白原(FBG)、白細胞計數(WBC)、C 反應蛋白(CRP)等指標；併觀察總住院時間、ICU 住院時間等。結果治療1週後治療組氧閤指數較對照組有明顯改善， CRP 水平則較對照組有明顯下降，差異有統計學意義(P 均<0.01)；APACH Ⅱ評分較對照組降低，差異有統計學意義(P<0.05)。結論聯閤小劑量肝素治療可明顯改善重癥肺炎患者氧閤及降低炎癥介質的水平，降低 APACHE Ⅱ評分。
목적：탐토연합소제량간소치료중증폐염적안전성급유효성。방법32례진단명학、몰유간소사용금기증적중증폐염환자채용수궤대조분조적판법분위치료조급대조조，각16례。치료조동시응용200 U/(kg·d)보통간소분차피하혹정맥급약、련속사용7 d ；대조조급여안위제처리。감측량조환자치료전후적급성생리여만성건강평분(APACHE Ⅱ평분)、양합지수、혈소판계수、활화부분응혈활매시간(APTT)、섬유단백원(FBG)、백세포계수(WBC)、C 반응단백(CRP)등지표；병관찰총주원시간、ICU 주원시간등。결과치료1주후치료조양합지수교대조조유명현개선， CRP 수평칙교대조조유명현하강，차이유통계학의의(P 균<0.01)；APACH Ⅱ평분교대조조강저，차이유통계학의의(P<0.05)。결론연합소제량간소치료가명현개선중증폐염환자양합급강저염증개질적수평，강저 APACHE Ⅱ평분。
Objective To investigate the safety and effectiveness of combined treatment by small dose of heparin for severe pneumonia. Methods A total of 32 diagnosed severe pneumonia patients without contraindication for heparin were randomly divided into treatment group and control group, with 16 cases in each group. The treatment group received 200 U/(kg·d) of heparin by fractional subcutaneous or intravenous administration for 7 d. The control group received placebo. Acute physiology and chronic health evaluation (APACHE Ⅱ score), oxygenation index, blood platelet count, activated partial thromboplastin time (APTT), fibrinogen (FBG), white blood count (WBC), and C-reactive protein (CRP) of the two groups were monitored before and after treatment. Their total hospital stay and ICU time were observed. Results After 1 week of treatment, the treatment group had more obviously increased oxygenation index and decreased CRP level than the control group. The differences had statistical significance (all P<0.01). The treatment group had more decreased APACHE Ⅱscore than the control group, and their difference had statistical significance (P<0.05). Conclusion Combined treatment by small dose of heparin for severe pneumonia can obviously improve oxygenation index and reduce inflammatory mediator level and APACHE Ⅱ score of patients.
