低分子肝素联合BiPAP通气对COPD合并呼吸衰竭患者肺功能及微循环的影响  

Effects of Low Molecular Weight Heparin Combined with BiPAP Ventilation on Pulmonary Function and Microcirculation in Patients with COPD and Respiratory Failure

作　　者：郭海江 杨奉华 GUO Hai-jiang;YANG Feng-hua(Department of Internal Medicine,Hekou District Traditional Chinese Medicine Hospital,Dongying,Shandong Province,257234 China)

机构地区：[1]东营市河口区中医院内二科,山东东营257234

出　　处：《系统医学》2020年第12期48-50,共3页Systems Medicine

摘　　要：目的探讨低分子肝素联合双水平正压通气(BiPAP)对慢性阻塞性肺疾病(COPD)合并呼吸衰竭患者应用效果。方法选择2019年1—9月于该院接受治疗的COPD合并呼吸衰竭患者98例,随机分为对照组及观察组,各49例。对照组予以常规治疗+BiPAP,观察组在对照组基础上+低分子肝素,治疗7 d后,比较相关生理参数。结果治疗后,观察组白微栓数量、血浆黏度、低切黏度、全血高切值[(1.22±0.15)个/min、(1.22±0.21)mPa·s、(9.78±0.97)m Pa·s、(4.21±0.51)mPa·s]均比对照组[(1.36±0.33)个/min、(1.56±0.31)mPa·s、(10.58±1.12)mPa·s、(4.72±0.61)m Pa·s]低,观察组微血管血流速度[(845.14±50.97)μm/s]则比对照组[(815.52±50.01)μm/s]高,差异有统计学意义(t=2.704、6.356、3.780、4.490、2.904,P=0.008、0.000、0.000、0.000、0.005);治疗后,观察组FEV1、FEV1/FVC水平[(1.99±0.62)L、(72.45±6.72)%]比对照组[(1.72±0.58)L、(60.68±6.75)%]高,差异有统计学意义(t=2.226、8.650,P=0.028、0.000)。结论低分子肝素联合BiPAP对COPD合并呼吸衰竭患者临床应用显著,可有效改善肺功能及微循环,促使患者疾病转归。Objective To explore the effect of low molecular weight heparin combined with bilevel positive pressure ventilation(BiPAP) on patients with chronic obstructive pulmonary disease(COPD) complicated with respiratory failure.Methods A total of 98 patients with COPD and respiratory failure who were treated in the hospital from January to September 2019 were randomly divided into a control group and an observation group, with 49 cases in each. The control group was given conventional treatment + BiPAP, and the observation group was based on the control group +low molecular weight heparin. After 7 days of treatment, the relevant physiological parameters were compared. Results After treatment, the number of white microthrombi, plasma viscosity, low-cut viscosity, high-cut value of whole blood[(1.22±0.15)/min,(1.22±0.21) mPa·s,(9.78±0.97) mPa·s,( 4.21 ±0.51) mPa·s], lower than the control group [(1.36 ±0.33)/min,(1.56±0.31) mPa·s,(10.58±1.12) m Pa·s,(4.72±0.61) mPa·s] The microvessel blood flow velocity in the observation group [(845.14±50.97)μm/s] was higher than that in the control group [(815.52±50.01)μm/s], the difference was statistically significant(t=2.704, 2.904, 6.356, 3.780, 4.490, P=0.008, 0.005, 0.000, 0.000, 0.000);after treatment,the FEV1, FEV1/FVC levels of the observation group [(1.99±0.62) L,(72.45±6.72)%] were higher than the control group [(1.72±0.58) L,(60.68±6.75)%], the difference was statistically significant(t=2.226, 8.650, P=0.028, 0.000).Conclusion Low molecular weight heparin combined with BiPAP has significant clinical application in patients with COPD and respiratory failure, which can effectively improve lung function and microcirculation, and promote the patients’ disease outcome.

关 键 词：慢性阻塞性肺疾病 呼吸衰竭 低分子肝素 双水平正压通气 微循环 

分 类 号：R4[医药卫生—临床医学]