老年慢性阻塞性肺疾病合并肺心病急性发作期治疗中低分子肝素的应用价值分析  

Analysis of the application value of low molecular weight heparin in the treatment of elderly patients with chronic obstructive pulmonary disease and acute episode of cor pulmonale

作　　者：陈明勇[1] 朱静[1] 吴友茹[1] 李丹[1] 王康 王蓉[1] 范小兵 Chen Mingyong;Zhu Jing;Wu Youru;Li Dan;Wang Kang;Wang Rong;Fan Xiaobing(Department of Respiratory and Critical Care Medicine,the Central Hospital of Mianyang City,Sichuan Mianyang 621000)

机构地区：[1]绵阳市中心医院呼吸与危重症医学科,四川绵阳621000

出　　处：《中国社区医师》2020年第26期21-22,共2页Chinese Community Doctors

摘　　要：目的:探讨低分子肝素治疗老年慢性阻塞性肺疾病(COPD)合并肺心病急性发作期的应用价值。方法:2018年1月-2019年12月收治老年COPD合并肺心病急性发作期患者86例,随机分为两组,各43例。对照组采用常规治疗;观察组在常规治疗基础上采用低分子肝素治疗。比较两组治疗效果。结果:观察组治疗有效率明显高于对照组,差异有统计学意义(P<0.05);观察组治疗7 d后第1秒用力肺活量百分比(FEV1%)、肺总量(TLC)、最大吸气压(PIMAX)及最大呼气压(PEMAX)等指标水平均明显高于对照组,而功能残气量(FRC)水平明显低于对照组,差异有统计学意义(P<0.05);观察组治疗7 d后动脉血氧含量(CaO2)、动脉血氧分压(PaO2)及氧供给(DO2)水平均明显高于对照组,而氧耗(VO2)及动-静脉血氧含量差(Ca-VO2)水平明显低于对照组,差异有统计学意义(P<0.05)。结论:应用低分子肝素治疗老年COPD合并肺心病急性发作期的价值显著,能有效改善机体血液黏稠度,增加肺血液供应,促进肺部氧合能力的提高,改善肺功能。Objective:To investigate the application value of low molecular weight heparin in the treatment of chronic obstructive pulmonary disease with acute episode of cor pulmonale.Methods:From January 2018 to December 2019,86 elderly patients with chronic obstructive pulmonary disease and acute episode of cor pulmonale were enrolled,they were randomly divided into two groups with 43 cases in each group.The control group was treated with conventional treatment and the observation group was treated with low molecular weight heparin on the basis of conventional treatment.The therapeutic effects between the two groups was compared.Results:The effective rate of treatment in observation group was significantly higher than that in control group,the difference was statistically significant(P<0.05).After 7 days of treatment,the forced vital capacity percentage in 1st second(FEV1%),the total lung volume(TLC),the maximum inspiratory pressure(PIMAX)and maximum expiratory pressure(PEMAX)levels of the observation group were all higher than that of control group,the functional residual capacity(FRC)level was significantly lower than that of the control group,the differences were statistically significant(P<0.05).After 7 days of treatment,the content of arterial blood oxygen(CaO2),the pressure of partial arterial blood oxygen(PaO2)and oxygen supply(DO2)in the observation group were significantly higher than those in the control group,the oxygen consumption(VO2)and arterial-venous oxygen content difference(Ca-VO2)levels were significantly lower than those of control group,the differences were statistically significant(P<0.05).Conclusion:Low molecular weight heparin is valuable in the treatment of chronic obstructive pulmonary disease(COPD)with acute episode of cor pulmonale in the elderly people,it can effectively improve the blood viscosity of the body,increase the blood supply of the lung,promote the improvement of pulmonary oxygenation ability and it can improve the lung function.

关 键 词：老年 慢性阻塞性肺疾病合并肺心病 急性发作期 低分子肝素 应用价值 

分 类 号：R563.9[医药卫生—呼吸系统] R541.5[医药卫生—内科学]