低分子肝素对脓毒症急性肾损伤患者的疗效评价  

Efficacy Evaluation of Low Molecular Weight Heparin in Patients with Acute Kidney Injury Induced by Sepsis

作　　者：尤伟艳[1] 任珊[1] 朱桂云[1] 于明基 YOU Wei-yan;REN Shan;ZHU Gui-yun;YU Ming-ji(Department of Critical Care Medicine,the First Affiliated Hospital of Shihezi University School of Medicine,Shihezi,Xin jiang,832000 China)

机构地区：[1]石河子大学医学院第一附属医院重症医学一科,新疆石河子832000

出　　处：《中外医疗》2018年第26期138-140,共3页China & Foreign Medical Treatment

摘　　要：目的探讨低分子肝素钠对脓毒症急性肾损伤患者的临床疗效。方法方便选取2015年6月—2017年6月该院收治的78例脓毒症急性损伤患者,按照治疗方式不同将其分为常规组(39例)和观察组(39例),常规组患者接受常规基础治疗,观察组患者在此基础上加用低分子肝素钙治疗,并比较不同组治疗前后凝血功能和肾功能以及生存率。结果治疗前,观察组和常规组患者血清肌酐(Scr)、尿素氮(BUN)、胱抑素(CysC)、凝血酶原时间(PT)、血小板(PLT)、纤维蛋白(FIB)和D-二聚体等指标比较差异无统计学意义(P>0.05),治疗后,观察组患者Scr、BUN、CysC、PT、PLT、FIB和D-二聚体等指标均明显优于常规组和治疗前(P<0.05);观察组患者死亡率与常规组患者死亡率(2.56%vs. 12.82%)比较相近差异无统计学意义(χ~2=2.889,P=0.089)。结论低分子肝素能显著改善脓毒症急性肾损伤患者凝血功能和肾功能,但对预后生存无显著影响。Objective To investigate the clinical efficacy of low molecular weight heparin sodium in patients with acute kid- ney injury caused by sepsis. Methods A total of 78 patients with acute sepsis admitted to the hospital from June 2015 to June 2017 were convenient selected and enrolled. The patients were divided into the conventional group （39 eases） and the observation group（39 eases） according to different treatment methods. In the conventional basic treatment, the patients in the observation group were treated with low molecular weight heparin calcium, and the coagulation function and renal function and survival rate before and after treatment were compared. Results Before treatment, serum creatinine （Set）, urea nitrogen （BUN）, cystatin （CysC）, prothrombin time （PT）, platelet （PLT）, fibrin （FIB） and D- were observed in the observation group and the conventional group. There were no significant differences in the indicators such as dimer （P〉0.05）. After treatment, the indicators of Set, BUN, CysC, PT, PLT, FIB and D-dimer in the observation group were significantly better than the conventional group and before treatment （P〈0.05）; the mortality of the observation group was not significantly different from that of the conventional group （2.56% vs. 12.82%）（χ^2=2.889, P=0.089）. Conclusion Low molecular weight heparin can significantly improve coagulation function and renal function in patients with acute kidney injury of sepsis, but has no significant effect on prognosis.

关 键 词：脓毒症 急性肾损伤 低分子肝素 临床疗效 

分 类 号：R5[医药卫生—内科学]