低分子肝素雾化吸入治疗ali fards的临床研究

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1、目录一．英文缩略词表·······································2二．摘要中文摘要············································3英文摘要············································5三．正文前言···············································7对象与方法·········································8结果·······················

2、························12讨论···············································18结论···············································27参考文献···········································28四．附录1···············································34五．致谢············································

3、···35六．综述···············································36七．附录2··············································47英文缩略词表英文缩写ALIARDSLMWHOIIRDSMODSSIRSPAI-1TFBALAPCATIIIPAPMNTNF-aPLTAPTTTFPIIL-6SPSSTabFigP英文全名acutelunginjuryacuterespiratorydistresssyndromelowmolecularweightheparinox

4、ygenationindexinfantilerespiratorydistresssyndromemultipleorgandysfunctionsyndromesystemicinflammatoryresponsesyndromeplasminogenactivatorinhibitor-1tissuefacterbronchialalveolarlavagefluidactivatedproteinCantithrombinIIIplasminogenactivatorpolymorphonuclearneutrophilstumornecro

5、sisfactorplateletsactivatedpartialthromboplastintimetissuefactorpathwayinhibitorinterleukin6StatisticalProductandServiceSolutionsTableFigureProbability1中文名称急性肺损伤急性呼吸窘迫综合症低分子肝素氧合指数婴儿呼吸窘迫综合症多器官功能障碍综合征全身炎症反应综合征纤溶酶原活化物抑制因子-1组织因子支气管肺泡灌洗液活化蛋白C抗凝血酶III纤溶酶原激活剂多形核粒细胞肿瘤坏死因子-a血小板活化部分凝血活酶时间

6、组织因子通道抑制剂白细胞介素-6统计产品与服务解决方案表图概率低分子肝素雾化吸入治疗ALI/ARDS的临床研究中文摘要目的：探讨雾化吸入低分子肝素治疗急性肺损伤的临床疗效及可能的作用机制。方法：（1）实验分组：选择2010年05月至2012年01月期间，在我院急诊ICU收治的确诊为ALI/ARDS患者42例随机分为三组。对照组9人，低分子肝素皮下注射组15人，低分子肝素雾化吸入组18人。（2）实验方法：所有病例确诊后立即常规给予治疗原发病，早期给予广谱强效抗生素抗感染，营养支持，维持水电解质酸碱平衡，肺保护通气策略指导下的机械通气，超声雾化吸入化痰药物

7、，防止并发症等综合治疗，皮下组在常规疗法上给予低分子肝素钠5000IU皮下注射，Q12H一次，雾化组常规治疗基础上雾化吸入5000IU，Q12H一次，每次半小时。抗凝治疗时间均为7天。结果：三组比较:(1)治疗前三组氧合指数（OI）无明显差异（P>0.05）。各组治疗7天后OI均较治疗前升高（P均<0.05），三组间氧合指数不全相同（P<0.05）。两两比较：皮下组高于对照组（P<0.05），雾化组高于对照组（P<0.05），雾化组高于皮下组（P<0.05）；(2)治疗前三组IL-6差异无统计学意义（P>0.05）。各组治疗后IL-6的含量较治疗前均有

8、下降（P均<0.05）。三组治疗后IL-6变化不全相同（P<0.05）,进一步两两比较：皮下组