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目的观察低分子肝素钙对慢性肺源性心脏病的辅助治疗作用。方法 76例慢性肺源性心脏病的患者分为治疗组40例,对照组36例。两组患者均给予低流量吸氧,抗感染,解痉,平喘,扩冠,利尿,化痰,纠正电解质紊乱,必要时给予糖皮质激素等综合治疗,治疗组加用低分子肝素钙4000IU,每12小时皮下给药,疗程7天,记录两组患者治疗前后的临床症状,血气分析,凝血功能及D-二聚体的变化情况,以及两组患者的住院天数。结果低分子肝素钙治疗组的临床疗效优于对照组,但差异无显著性(P>0.05),氧分压(PaO_2)及二氧化碳分压(PaCO_2)明显改善,血浆凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、国际标准化比值(INR)、凝血酶原活动度(PA)明显降低,D-二聚体下降,差异有显著性(P<0.05),患者住院天数两组间比较,差异有显著性(P<0.05),未见明显不良反应。结论常规治疗慢性肺源性心脏病的基础上加用抗凝治疗,可以缩短住院时间,改善患者症状,改善缺氧及二氧化碳的潴留,并可以降低血液的高凝状态。
Objective To observe the adjuvant therapeutic effect of low molecular weight heparin on chronic cor pulmonale. Methods 76 patients with chronic cor pulmonale were divided into treatment group (40 cases) and control group (36 cases). Both groups were given low-flow oxygen, anti-infective, antispasmodic, antiasthmatic, crown expansion, diuretic, phlegm, electrolyte imbalance correction, if necessary, given glucocorticoid and other comprehensive treatment, the treatment group with low molecular weight heparin 4000IU , Administered subcutaneously every 12 hours for 7 days. The clinical symptoms, blood gas analysis, coagulation function and D-dimer changes were recorded before and after treatment in both groups, as well as the days of hospitalization in both groups. Results The therapeutic effect of low molecular weight heparin calcium group was better than that of the control group, but the difference was not significant (P> 0.05). PaO2 and PaCO2 were significantly improved, while the prothrombin time (PT) (APTT), international standardization ratio (INR), prothrombin activity (PA) and D-dimer decreased significantly (P <0.05) There was significant difference between groups (P <0.05), no obvious adverse reaction was found. Conclusion The conventional treatment of chronic pulmonary heart disease with anticoagulant therapy can shorten the length of hospital stay, improve the symptoms of patients, improve the hypoxia and carbon dioxide retention, and can reduce blood hypercoagulability.