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1、低分子肝素钙对肺心病急性发作并呼吸衰竭疗效观察【摘要】目的研究低分子肝素钙对肺源性心脏病急性发作并呼吸衰竭的疗效。方法对39例肺心病急性发作并呼吸衰竭患者按随机双盲法分为观察组A20例，对照组B19例，A、B两组的常规治疗如抗感染、氧疗、改善通气、强心、利尿等相同，仅观察组A用低分子肝素钙5000IU于腹壁皮下注射�2次/d�，10d为1个疗程，监测A、B两组治疗前后血气pH、PaO2、PaCO2，全血高切黏度、红细胞比容及纤维蛋白原，并观察A、B两组临床疗效(水肿、紫绀、哮喘，心率及肺部�音的变化)及病死率。结果治疗后A组较B组心肺功能明显
2、改善，红细胞比容和全血高切黏度明显降低，PaCO2降低，PaO2明显增高，A组临床总有效率高于B组，A组病死率低于B组。结论低分子肝素钙皮下注射可改善肺心病急性发作并呼吸衰竭患者的心肺功能、血液性状及通气，且能提高临床总有效率，降低病死率。�【关键词】低分子肝素钙；肺心病；呼吸衰竭Clinicalobservationoflowmolecularheparincalcium’sefficacyonacuteattackofpulmonaryheartdiseaseandrespiratoryfailureBAIYang,QIUXiao-min
3、g.GuangzhouDongshen7Hospital,510120Dongshen,China�【Abstract】ObjectiveTostudythecurativeeffectoflowmolecularheparincalciumonacuteattackofpulmonaryheartdiseaseandrespiratoryfailure.Methods39patientssufferedfromtheacuteattackofpulmonaryheartdiseaseandtherespiratoryfailurewered
4、ividedintotheobservationgroupA20andthecontrolgroupB19inaccordancewithrandomdoubleblindmethod,thenormaltherapyofAandBgroupswerethesame,suchasanti-infection,oxygentherapy,ventilationimprovement,heartstimulation,diuresisandsoon,buttheobservationgroupAwasinjectedundertheabdomin
5、alskinwith5000IUlowmolecularheparincalciumtwiceeveryday.Onetreatmentcourseincludes10days.Then,toobservethebloodpH,PaO2andPaCO2,wholebloodviscosityathighshear,redbloodcellspecificvolumeandfibrinogenafterthetherapyforAandBgroups,andtoobservetheclinicalefficacy(ondropsy,cyanos
6、is,asthma,thechangeofheartrateandlungrate)andfatality7rateofAandBgroups.ResultsThecardio-pulmonaryfunctionofGroupAwasimprovedobviouslywhilecomparedwithGroupB,whilethespecificvolumeofredbloodcellsandthewholebloodviscosityathighsheardecreaselargely,PaCO2)reducedandPaO2risedev
7、idently.ThegrossclinicalefficacyofGroupAwashigherthanthatofGroupB,whilethefatalityrateofGroupAwaslowerthanthatofGroupB.ConclusionThesubcutaneousinjectionoflowmolecularheparincalciumcanimprovethecardio-pulmonaryfunction,bloodpropertyandventilationofthepatientssufferedfromthe
8、acuteattackofpulmonaryheartdiseaseandrespiratoryfailure,andcanincreasethegrossclin
