摘要
目的 探讨血塞通对慢性阻塞性肺疾病(COPD)伴肺性脑病且已接受无创正压通气(NPPV)患者动脉血气、血液高凝状态及格拉斯哥评分(GCS)的影响。方法 2020年5月至2022年2月我院收治的COPD伴肺性脑病患者76例,以单双号随机分为治疗组和对照组各38例。均给予对症与支持疗法、NPPV治疗,期间病情加重时予有创机械通气,治疗组加用血塞通治疗。观察患者动脉血气、凝血状态及GCS变化。结果 两组治疗7 d后pH值、氧分压(PaO_(2))、二氧化碳分压(PaCO_(2))与血浆活化部分凝血活酶时间(APTT)、凝血酶原时间(PT)、纤维蛋白原(Fib)及D-二聚体(D-D)均较治疗前明显改善(P<0.05),且治疗组pH值、PaO_(2)、APTT、PT明显高于对照组,PaCO_(2)、Fib、D-D明显低于对照组(P<0.05)。两组治疗后1、3、7 d GCS评分均较前升高(P<0.05),治疗组治疗后3、7 d GCS评分显著高于对照组(P<0.05)。治疗组无创通气时间、住院时间显著短于对照组,气管插管率明显低于对照组(P<0.05),两组院内死亡率差异无统计学意义(P>0.05)。结论 对于COPD伴肺性脑病患者,血塞通联合NPPV可有效促使动脉血气、血液高凝状态及意识障碍改善,从而可优化预后。
Objective To investigate the effects of Xue-sai-tong on arterial blood gas, blood hypercoagulability and Glasgow Score(GCS) in patients with chronic obstructive pulmonary disease(COPD) and pulmonary encephalopathy undergoing non-invasive positive pressure ventilation(NPPV).Methods Seventy-six patients with COPD and pulmonary encephalopathy admitted to our hospital from May 2020 to February 2021 were randomly assigned to a treatment group and a base group according to the order of admission, 38 in each group. All patients were given symptomatic and supportive treatments together with NPPV. Invasive mechanical ventilation was used when the patient′s condition deteriorated. The treatment group was additionally treated with Xue-sai-tong. Changes in arterial blood gas, coagulation state and GCS score were observed.Results After 7 day of treatment, pH, partial pressure of oxygen(PaO_(2)), partial pressure of carbon dioxide(PaCO_(2)) and plasma activated partial thromboplastin time(APTT), prothrombin time(PT), fibrinogen(Fib) and D-dimer(DD) in the two groups were significantly improved when compared with those before treatment(P<0.05). Compared with the control group after treatment, the pH value and PaO_(2)in the treatment group were significantly higher, PaCO_(2)was significantly lower, APTT and PT were significantly prolonged, and Fib and DD were significantly lower(P < 0.05). The GCS scores of the two groups were gradually increased after 1 day, 3 and 7 days of treatment(P<0.05), and the GCS scores of the treatment group were significantly higher than those of the control group after 3 and 7 days of treatment(P<0.05). The time of non-invasive ventilation and hospitalization in the treatment group was significantly shorter, and the rate of tracheal intubation was significantly lower than those in the control group(P<0.05). There was no significant difference in hospital mortality between the two groups(P>0.05).Conclusions Xue-sai-tong combined with NPPV can effectively improve the arterial blood gas, hypercoagulab
作者
张敏
兰细香
杜珊
刘会子
ZHANG Min;LAN Xi-xiang;DU Shan;LIU Hui-zi(Hubei 672 Orthopaedics Hospital of Integrated Traditional Chinese and Western Medicine,Wuhan 430079,China)
出处
《实用医院临床杂志》
2023年第1期128-131,共4页
Practical Journal of Clinical Medicine
关键词
血塞通
无创机械通气
慢性阻塞性肺疾病
肺性脑病
格拉斯哥评分
Xue-sai-tong
Non-invasive mechanical ventilation
Chronic obstructive pulmonary disease
Pulmonary encephalopathy
Glasgow Score
