小剂量肝素钠联合红花黄色素对慢性阻塞性肺疾病急性加重期患者机械通气时间和呼吸机相关性肺炎发生率及脱机后住院时间的影响

摘要

Objective To explore the effect of low dose heparin sodium combined with safflower yellow on mechanical ventilation duration,ventilator-associated pneumonia(VAP) and length of hospital stay in patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD).Methods Forty patients with AECOPD admitted to the First Affiliated Hospital of Hebei North University from September 2015 to August 2016 were randomly divided into observation group and control group,with 20 cases in each group.The control group had invasive mechanical ventilation and routine western medicine;the observation group was given intravenous administration of low dose heparin (during ventilation) and safflower yellow (14 days for 1 course of treatment).After 1 course of treatment,mechanical ventilation duration,success rate of weaning,hospitalization time after weaning and incidence of VAP were analyzed.Results Mechanical ventilation time and hospitalization time after weaning in observation group were significantly shorter than those in control group[(9 ±4)d vs (14 ±8)d,(14 ±7)d vs (20 ± 9) d];the 2-week weaning success rate in observation group was significantly higher than that in control group[80.0％ (16/20) vs 45.0％ (9/20)] (all P ＜0.05).Incidence of VAP in observation group was significantly lower than that in control group[15.0％ (3/20) vs 45.0％ (9/20)] (P ＜0.001).Conclusion Low dose heparin sodium combined with safflower yellow treating AECOPD can effectively shorten mechanical ventilation and hospitalization time and reduce the incidence of VAP.%目的 探讨小剂量肝素钠联合红花黄色素对慢性阻塞性肺疾病急性加重期(AECOPD)患者机械通气时间、呼吸机相关性肺炎(VAP)发生率及脱机后住院时间的影响.方法 选取2015年9月至2016年8月河北北方学院附属第一医院收治的AECOPD患者40例作为研究对象,按照随机数字表法分为观察组和对照组,各20例.对照组给予有创机械通气以及常规西医治疗,观察组在此基础上加用小剂量肝素钠(疗程从开始机械通气至脱机)和红花黄色素(14 d为1个疗程)静脉输注治疗.治疗后比较2组机械通气时间、2周脱机成功率、脱机后住院时间以及VAP发生率.结果 观察组机械通气时间和脱机后住院时间均明显短于对照组[(9±4)d比(14±8)d、(14±7)d比(20±9)d],2周脱机成功率明显高于对照组[80.0％ (16/20)比45.0％ (9/20)],差异均有统计学意义(均P＜0.05).观察组患者VAP发生率明显低于对照组[15.0％(3/20)比45.0％ (9/20)],差异有统计学意义(P＜0.001).结论 小剂量肝素钠联合红花黄色素能够有效缩短AECOPD患者机械通气时间、脱机后住院时间,并降低VAP发生率.