持续小剂量肝素治疗脓毒症患者急性肺损伤/急性呼吸窘迫综合症的临床研究被引量：16

The clinical study on acute lung injury/acute respiratory distress syndrome with sepsis treated with continuous low dose heparin

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摘要目的探讨持续小剂量肝素对脓毒症患者急性肺损伤/急性呼吸窘迫综合症的治疗作用。方法 119例脓毒症患者随机分为对照治疗组(61例)和肝素治疗组(58例),对照组采用抗感染、呼吸支持等综合治疗,肝素组在对照治疗基础上加用持续小剂量肝素输注,比较两组患者治疗3天后氧合指数,APACHEⅡ积分,SOFA积分以及PLT、PT、APTT、FIB变化以及出血倾向。结果肝素组治疗后氧合指数明显好转,APACHEⅡ积分,SOFA积分明显低于对照组(P<0.05),PLT、PT、APTT、FIB两组治疗前后均无差异。结论持续小剂量肝素治疗严重脓毒症患者急性肺损伤/急性呼吸窘迫综合症可有效提高氧合指数,减轻患者炎症反应,且具有良好的安全性。 Objective To investigate the therapeutic effect of continuous low dose heparin therapy on acute lung injury/acute respiratory distress syndrome with sepsis.Methods Patients with acute lung injury/acute respiratory distress syndrome sepsis（119 cases） were randomly divided into two groups：heparin groups（58 cases） and control groups（61 cases）.The patients in the control groups were given with conventional therapy including anti-infection and mechanical ventilation therapy;and the patients in heparin groups were treated with continuous intravenous drip infusion on the basis of conventional therapy.Oxygenation index,Acute Physiologic and Chronic Healthy Evaluation（APACHE Ⅱ） score,Sepsis-related organ failure assessment（S0FA score）,blood platelet count（PLT）,prothrombin time（PT）,activated partial thromboplastin time（APTT）,thrombin time（TT）,plasma fibrinogen（FDP） between heparin group（3 days after） and control group were compared.Results The oxygenation index improved significantly,and the APACHEⅡ score,SOFA score on 3th day after treatment in heparin group was markedly decreased than that of conventional group.There were no difference in PLT,PT,APTT,TT,and FDP levels between two groups.Cnclusion Continuous low dose of heparin is safety and benefit to improve the oxygenation index in acute lung injury/acute respiratory syndrome with sepsis.

作者韩旭东黄晓英葛志华王亚东张素燕任轲孙维维

机构地区南通大学附属南通三院重症医学科

出处《临床肺科杂志》 2010年第12期1730-1732,共3页 Journal of Clinical Pulmonary Medicine

关键词肝素脓毒症急性肺损伤/急性呼吸窘迫综合症氧合指数 APACHEⅡ SOFA heparin sepsis acute lung injury/acute respiratory syndrome oxygenation index APACHE Ⅱ、SOFA

分类号 R563.8 [医药卫生—呼吸系统]

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