摘要
目的评价在常规治疗的基础上加用超微量肝素治疗微循环障碍疾病的疗效。方法随机将符合诊断标准的78例微循环障碍病儿分为对照组和治疗组。常规组给予液体复苏、氧疗或呼吸支持、血管活性药物、保护重要脏器、应用抗菌素及去除病因等常规疗法。治疗组在常规组基础上加用肝素,4～6u/(kg·次),静脉或皮下注射,好转后减少注射次数。定期监测两组患儿的尿量、皮温和CRT、精神状态、LAC。分别于第24、48、72小时采血观察PLT、PT、APTT、TT、FBG、FIB和DD等指标。并统计治疗最后发生DIC例数,死亡率、平均住院时间。结果与对照组比较,除PUV和FIB外,治疗组精神状态、皮温及CRT、乳酸等指标在治疗48或72小时后改善更为显著(P<0.01);而在凝血指标上PLT、PT、APTT、TT、FBG、DD等治疗72小时后改善也更为显著(P<0.01或P<0.05),死亡率及平均出院时间也显著少于对照组(P<0.05,P<0.01)。结论常规治疗的基础上加用超微量肝素有助于临床症状的恢复,减轻凝血因子的激活,提高抗凝能力及促进纤溶的恢复,阻止广泛的器官栓塞、坏死,阻碍MSOF的发生,从而降低死亡率。
Objective To evaluate the clinical effect of complementary therapy of ultramicro heparin used for micro-circulatory-disturbance on base of routine therapy.Methods 78 cases of children patients that fit for diagnose standard of micro-circulatory-disturbance were randomly divided into control groups and therapy group.Routine treatment such as fluid resuscitation,oxygen therapy or respiratory support,vasoactive drugs,protecting important viscera,applying antibiotic and wiping off disease cause were used for control group.Complementary therapy of ultramicro heparin was used for treatment group on base of control group,4-6u/kg one time,mainline or hypodermic,and decreased times of injection after the disease turning better.the PUV,skin temperature,CRT,mental state and LAC were monitored on time,the PLT、PT、APTT、TT、FBG and DD were detected at time of 24h,48h and 72h after injection.The DIC case,death rate and hospital time were recorded,too.Results Compared with control group,except of PUV and FIB,the improving degrees of skin temperature,CRT,mental state and LAC in treatment group were more significant after 48h or 72h of therapy;about clotting index（P〈0.01）,the PT、APTT、TT、FBG、DD were more significant after 72h of therapy（P〈0.01 or P〈0.05）.the death rate and hospital time were significantly shorter,too（P〈0.01,P〈0.05）.Conclusion Complementary therapy of ultramicro heparin used for micro-circulatory-disturbance on base of routine therapy,can prompt recovery,decrease the activation of blood coagulation factor,enhance anti-freezing and fibrinolysis,prevent the incidence of MSOF and abnormity of many organs,to the aim of decreasing of death rate.
出处
《当代医学》
2011年第21期7-9,共3页
Contemporary Medicine
