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目的观察低分子肝素对重症中暑合并凝血功能异常患者的临床疗效。方法将确诊为重症中暑合并凝血功能异常的病例随机分为小剂量低分子肝素治疗组(17例)和对照组(14例),观察两组患者治疗前后的炎症因子、血小板计数、D-二聚体、凝血功能、APACHEⅡ评分、氧合指数、机械通气时间及死亡例数的变化。结果随着治疗时间的延长,治疗组血小板计数、氧合指数较对照组明显上升(均P<0.05);治疗组血清活化部分凝血酶时间(APTT)、血浆凝血酶原时间(PT)、APACHEⅡ评分、D-二聚体较对照组明显下降(均P<0.05);治疗组机械通气时间较对照组明显缩短(P<0.05)。结论小剂量低分子肝素可以明显改善重症中暑合并凝血功能异常患者的凝血功能异常,可以防止弥漫性血管内凝血的发生,缩短机械通气时间。
Objective To observe the clinical effect of low molecular weight heparin on severe heat stroke patients with coagulation dysfunction. Methods The cases of severe heat stroke with coagulation dysfunction were randomly divided into low-dose low molecular weight heparin treatment group (n = 17) and control group (n = 14). Inflammatory factors, platelet count, D- Coagulation function, APACHEⅡscore, oxygenation index, time of mechanical ventilation and death cases. Results With the prolongation of treatment time, the platelet count and oxygenation index in the treatment group were significantly higher than those in the control group (all P <0.05). The serum levels of activated partial thromboplastin time (APTT), plasma prothrombin time (PT), APACHEⅡ D-dimer was significantly lower than the control group (all P <0.05). The duration of mechanical ventilation in the treatment group was significantly shorter than that in the control group (P <0.05). Conclusion Low-dose low-molecular-weight heparin can significantly improve coagulation dysfunction in severe heat stroke patients with coagulation dysfunction, prevent diffuse intravascular coagulation and shorten the duration of mechanical ventilation.