低分子肝素对老年重症肺炎患者病情和预后的影响

摘要

Objective To observe the effects of low molecular heparin on the state of illness and the prognosis of elderly patients with severe pneumonia .Methods Eighty‐four elderly patients with severe pneumonia were equally assigned into two groups .The patients in group B were treated with conventional therapy and those in group A were given additional subcutaneous injection of low molecular heparin 4000 U once a day for 7 days .On the 1st ,3rd and 7th day of treatment ,Acute Physiology and Chronic Health Evaluation Ⅱ (APACHE Ⅱ ) score was evaluated ,arterial blood gas analysis was performed ,the times of mechanical ventilation and ICU stay and mortality were calculated .Results On the 7th day of treatment ,APACHEⅡ score was lower and PaO2 was higher in group A than those in group B [(14.36 ± 4.01) points vs .(17.13 ± 4.81) points and (107.14 ± 34.59) mmHg vs .(90.61 ± 31.54) mmHg](P<0 .01) .The times of mechanical ventilation and ICU stay were shorter in group A than those in group B [(141.14 ± 107.32) hours vs .(189.71 ± 112.64) hours and (12.87 ± 6.36) days vs .(18.23 ± 5.81) days](P<0 .01or P<0 .05) .The mortality was lower in group A than that in group B(2.38% vs .14.29% )(P<0 .05) .Conclusion On the basis of conventional therapy ,additionally use of low molecular heparin may improve the state of illness and the prognosis of elderly patients with severe pneumonia .%目的：探讨低分子肝素对老年重症肺炎患者严重程度及近期预后的影响。方法老年重症肺炎患者84例随机均分为两组：对照组给予常规治疗；试验组加用低分子肝素4000 U 皮下注射，每天1次，疗程7d。分别于治疗1、3、7d进行急性生理功能和慢性健康状况评分系统Ⅱ（APACHEⅡ）评分，比较两组动脉血气变化、住ICU时间、呼吸机支持时间及病死率。结果治疗7 d ，试验组APACHEⅡ评分低于对照组[（14.36±4.01）分 vs ．（17.13±4.81）分]，PaO2值高于对照组[（107.14±34.59）mmHg vs ．（90.61±31.54）mmHg]（P＜0．01）。试验组呼吸机支持时间和住IC U时间短于对照组[（141.14±107.32） h v s ．（189.71±112.64） h和（12.87±6.36） d v s ．（18.23±5.81） d]（P＜0．01或P＜0．05），病死率低于对照组（2.38％ vs ．14.29％）（P＜0．05）。结论在常规治疗基础上，加用低分子肝素治疗能改善老年重症肺炎患者的病情和预后。