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目的观察应用肝素微量泵治疗慢性阻塞性肺疾病(COPD)急性加重期的疗效。方法全部78例病例均为重症COPD急性加重期合并Ⅱ型呼吸衰竭并机械通气患者,随机分为三组:微泵组、静脉滴注组和对照组,分别采用肝素微量泵、肝素静脉滴注和不使用肝素的治疗方法,观察各组患者血气分析(pH、PO2、PCO2、OI指数)、中心静脉压(CVP)、血沉(ESR)的变化和不良反应的发生率,比较各组有无显著性差异。结果三组患者治疗前后血气、中心静脉压、血沉均有明显改善,但使用肝素组(微泵组、静脉滴注组)疗效更为优胜,差异有统计学意义(P<0.05),而微泵组疗效较静脉滴注组疗效更可靠,而且不良反应少。结论对COPD急性加重期合并呼吸衰竭患者应用肝素抗凝治疗能有效改善肺循环,从而改善心肺功能,而采用静脉微量泵可作为首选方法。
Objective To observe the curative effect of heparin pump on acute exacerbation of chronic obstructive pulmonary disease (COPD). Methods All 78 patients were severe acute exacerbation of COPD with type Ⅱ respiratory failure and mechanical ventilation were randomly divided into three groups: micro pump group, intravenous drip group and control group, respectively, using heparin pump, heparin intravenous infusion And no treatment with heparin. The changes of blood gas analysis (pH, PO2, PCO2, OI index), central venous pressure (CVP), erythrocyte sedimentation rate (ESR) and the incidence of adverse reactions in each group were observed. Significant difference. Results Before and after treatment, blood gas, central venous pressure and erythrocyte sedimentation rate were significantly improved in all three groups. However, the effect of using heparin group (micro pump group and intravenous drip group) was superior to that of the control group (P <0.05) The curative effect of pump group is more reliable than that of intravenous drip group, and the adverse reactions are few. Conclusion The application of heparin anticoagulant therapy in patients with acute exacerbation of COPD complicated with respiratory failure can effectively improve pulmonary circulation and improve cardiopulmonary function. However, venous micropumps can be the preferred method.