预防性抗凝对慢性阻塞性肺疾病合并肺栓塞临床疗效的研究.docVIP

预防性抗凝对慢性阻塞性肺疾病合并肺栓塞临床疗效的研究 　　摘 要：目的：通过对慢性阻塞性肺疾病患者在常规治疗基础上，予低分子肝素进行预先抗凝，观察血浆中D-二聚体（D-dimer）含量以及动脉血氧分压（PaO2）、二氧化碳分压（PaCO2）等指标的变化及肺栓塞发生情况，以观察其疗效。方法：入院后予预先抗凝性治疗，采用低分子肝素钙2000AXaIU皮下注射，每日一次，共7天，予普通治疗进行对照，分别在入院1天、入院第7天测定患者血浆中D-二聚体（D-dimer）含量以及动脉血氧分压（PaO2）、二氧化碳分压（PaCO2）的变化。对D-二聚体（D-dimer）升高患者进一步检查，判断是否存在肺栓塞。结果：预先抗凝组在入院第1天，动脉血氧分压（PaO2）、二氧化碳分压（PaCO2）和静脉血浆中D-二聚体（D-dimer）含量差异无统计学意义；而在入院第7天后动脉血氧分压（PaO2）、二氧化碳分压（PaCO2）和静脉血浆中D-二聚体（D-dimer）含量水平差异均具有统计学意义（P0.01）。普通治疗组有6例经诊断为肺栓塞，预先抗凝组未发现肺栓塞病例。结论：预防性抗凝对治疗由慢性阻塞性肺疾病合并肺栓塞引起的肺血栓栓塞及血液高度凝集具有较好的治疗效果，能有效的预防慢性阻塞性肺疾病病人合并肺栓塞的发生，具有一定的临床意义与价值。 　　关键词：预防性抗凝；慢性阻塞性肺疾病；肺栓塞 　　Abstrac：Objective Based on chronic obstructive pulmonary disease on the basis of conventional treatment， to anticoagulate low molecular weight heparin in advance. Obeved in D-dimer content of the plasma and arterial blood oxygen partial pressure， CO2 partial pressure and the changes of pulmonary embolism to observe the curative effect..Methods After admission， anticoagulat treatment was used in advance， using low molecular heparin calcium 2000AXaIU， subcutaneous injection， once a day for seven days. Comparing with ordinary treatment， on the first day of admission， the hospital on the seventh day， determine the content of plasma D-dimer in patients and arterial blood pressure of subsection， the change of CO2 partial pressure. Getting futher inspection in patients with elevated D-dimer， then determine the presence of pulmonary embolism. Results Anticoagulant group on the first day of admission， there is no statistically significant differences in the arterial blood oxygen partial pressure， CO2 partial pressure， and the content D -dimer in plasama， and after 7 days admission， blood oxygen partial pressure， CO2 partial pressure and venous plasma D-dismer are statistically significant. 　　embolism.Conclusionprophylactic anticoagulation for treatment of chronic obstructive pulmonary disease complicating pulmonary embolism caused by pulmonary thromboembolism and blood pressure high agg