NCPAP联合低分子肝素对重症肺炎患者肺功能和血氧饱和度的影响  

Effect of NCPAP Combined with Low Molecular Weight Heparin on Pulmonary Function and Blood Oxygen Saturation in Patients with Severe Pneumonia

作　　者：张静[1] 杨芳[1] 张川[1] 杨玲[1] ZHANG Jing;YANG Fang;ZHANG Chuan;YANG Ling(Intensive Care Unit,the FitCh People＇s Hospital of Chengdu,Chengdu 611131,China)

机构地区：[1]成都市第五人民医院重症医学科,成都611131

出　　处：《解放军预防医学杂志》2018年第10期1277-1279,1282,共4页Journal of Preventive Medicine of Chinese People's Liberation Army

摘　　要：目的探讨经鼻持续气道正压通气(NCPAP)联合低分子肝素治疗重症肺炎的效果。方法选取2017年5月-2018年5月在我院治疗的重症肺炎患者103例,采用随机数字表法将患者随机分为观察组(n=53)和对照组(n=50),两组均给予常规治疗,其中观察组给予NCPAP联合低分子肝素,对照组仅给予低分子肝素,观察两组治疗效果、肺功能及血气指标。结果观察组治疗效果优于对照组(P<0.05),其总有效率为96.23%;观察组啰音消失时间、气促消失时间和住院时间分别为(3.72±1.02) d、(1.50±0.30) d和(9.20±1.04) d,均明显短于对照组(P<0.05);观察组治疗后第1秒最大呼气容积(FEV_1)、用力肺活量(FVC)和最高呼气流速(PEF)分别为(2.81±0.30) L、(3.98±0.51) L和(3.81±0.67) L/s,均明显高于对照组(P<0.05);观察组治疗后动脉血氧分压(PaO_2)和血氧饱和度(SpO_2)分别为(98.82±7.83) mmHg和(98.20±7.81)%,均明显高于对照组,而二氧化碳分压(PaCO_2)为(28.92±2.83) mmHg,明显低于对照组(P<0.05)。结论 NCPAP联合低分子肝素治疗重症肺炎有较好的效果,有助于改善患者的肺功能及血氧水平。Objective To investigate the therapeutic effect of nasal continuous positive airway pressure（ NCPAP） combined with low molecular weight heparin against severe pneumonia. Methods One hundred and three patients with severe pneumonia treated in our hospital between May 2017 and May 2018 were randomly divided into the observation group（ n = 53） and the control group（ n = 50） using the random digital table method. Both groups were given conventional treatment. The observation group was given NCPAP combined with low molecular weight heparin,while the control group received low molecular weight heparin only. The therapeutic effect,lung function and blood gas indexes of the two groups were observed. Results The therapeutic effect of the observation group was better than that of the control group（ P〈0.05）,and the total effective rate was 96.23%. The time taken for rale and short breath to disappear and hospital stay were（ 3.72±1.02） d,（ 1.50±0.30） d and（ 9.20±1.04） d respectively,which were significantly shorter than those in the control group（ P〈0.05）. The forced expiratory volume in one second（ FEV1）,forced vital capacity（ FVC） and peak expiratory flow（ PEF） of the observation group were（ 2.81±0.30） L,（ 3.98±0.51） L and（ 3.81±0.67） L/s respectively,which were significantly higher than those of the control group（ P〈0.05）.The arterial oxygen pressure（ PaO2） and oxygen saturation（ SpO2） of the observation group were（ 98.82±7.83） mmHg and（ 98.20±7.81） %respectively,which were significantly higher than those of the control group,while the carbon dioxide partial pressure（ PaCO2） was（ 28.92±2.83） mmHg,which was obviously lower than that of the control group（ P〈0.05）.Conclusion NCPAP combined with low molecular weight heparin has a good effect on severe pneumonia,which can help improve lung function and blood oxygen levels.

关 键 词：经鼻持续气道正压通气 低分子肝素 重症肺炎 肺功能 血气指标 

分 类 号：R563.1[医药卫生—呼吸系统]