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1、國際呼吸雜志2014年6月第34卷第1i期IntJRespir，June2014，Vo1．34，No．11·827·．論著低分子肝素早期干預(yù)對慢性阻塞性肺疾病急性加重期臨床療效的影響楊梅強麗霞金壽德【摘要】目的探討早期應(yīng)用低分子肝素對慢性阻塞性肺疾病急性加重期(AECOPD)臨床療效的影響。方法根據(jù)中華醫(yī)學(xué)會呼吸病學(xué)分會慢性阻塞性肺疾病學(xué)組制訂的COPD診斷標(biāo)準(zhǔn)，納入哈爾濱醫(yī)科大學(xué)附屬第四醫(yī)院呼吸內(nèi)科2009年8月一2012年1O月明確診斷AEC0PD的連續(xù)病例140例，隨機分為對照組(70例)和抗凝組(70例)。對照組患者均采用常規(guī)治療；抗凝組除常規(guī)治療，同時腹部皮下注射
2、低分子肝素，1次／d，10d為一個療程。所有患者在治療前后均進(jìn)行動脈血氣分析、I)
3、二聚體、肺功能檢測，并統(tǒng)計住院天數(shù)。結(jié)果AECOPD患者早期低分子肝素與常規(guī)治療聯(lián)合應(yīng)用較常規(guī)治療，明顯糾正凝血功能，改善肺功能，糾正低氧和二氧化碳潴留，縮短住院天數(shù)。結(jié)論AEcOPD早期低分子肝素與常規(guī)治療聯(lián)合應(yīng)用可明顯提高l臨床療效。【關(guān)鍵詞】低分子肝素；慢性阻塞性肺疾?。慌R床療效Theeffectoflowmolecularweightheparinonclinicalefficacyofacuteexacerbationsofchronicobstructivepulmonarydi
4、seaseYangMei，QiangLixia，JinShoude．DepartmentofRespiratoryMedicine，theFourthA~filiatedHospital，HaerbinMedicalUniversity，Haerbin150001，ChinaCorrespondingauthor：QiangLiria，Email：lx．qian163．com；JinShoude，Email：jinshoude@163．corn[Abstract]ObjectiveTOinvestigateclinicalefficacyofinterventionwith
5、low-molecular—weight—heparin(IMWH)onacuteexacerbationofchronicobstructivepulmonarydisease．MethodsAccordingtoCOPDdiagnosticcriteriadewdopedbytheChineseMedicalAssociationHospitalofHarbinMedicalUniversity，atotalofFourthAffiliatedHospitalofHaerbinMedicalUniversityfromAugust2009to0ctober2012．AI
6、lpatientswererandomlydividedintothecontrolgroupandtheanticoagulationgroup；meanwhile，thepatientsoftheformergroupweretreatedwithconventionaltherapy；Inadditiontoconventionaltherapy，anticoagulationgroupreceivedlowmolecularweightheparinbyabdominalsubcutaneousinjectiononceeveryday，withtendaysfor
7、acourse．Beforeandaftertreatment，thebothgroupsweredetectedarterialbloodgasanalysis，D-dimer，lungfunction，andtoadduphospitalday．ResultsThecombinationofconventionaltherapywithlow—molecular-weightheparinanticoagulationimprovedthebloodcoagulationandpulmonaryfunctionsofpatients，andcorrectedhypoxi
8、aandcarbondioxideretention，toshortenthehospitalday．ConclusionsThecombinationofconventionaltherapywithlow—molecular—weightheparinanticoagulationcansignificantlyimprovetheclinicalefficacyinacuteexacerbationofchronicobstructivepulmonarydiseaseearly．[Keywords]Lowm
