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乌司他丁治疗合并凝血功能障碍的危重患者临床效果评价
作者:崔颖  
单位:石家庄市中医院ICU
关键词:重症监护病房 凝血功能障碍 乌司他丁 血小板 
分类号:
出版年·卷·期(页码):2015··第九期(0-)
摘要:

目的:探讨乌司他丁对凝血功能障碍危重患者的临床效果。方法:将我院重症监护病房收治的60例凝血功能障碍危重患者根据数字表的方式随机分为对照组和观察组,每组³0例。对照组患者给予常规对症治疗,观察组患者在此基础上给予乌司他丁静脉注射,对比两组患者入院时及治疗¹周后血小板计数、凝血酶原时间、部分活化凝血酶原时间、Ð-Ð二聚体的数值差异;对比两组患者入院时及治疗¹周后的APACHE评分和ÐIC评分。结果:观察组患者治疗后的PLÞ[(¹55.8²±³8.96)×¹09/L]明显高于治疗前[(58.46±¹4.6²)×¹09/L]和对照组患者治疗后[(65.44±¹6.³6)×¹09/L],PÞ[(¹0.¹³±².54) s]和APÞÞ[(²7.45±6.87) s]明显短于治疗前[(¹8.95±4.74) s,(40.0¹±¹0.0¹) s]和对照组患者治疗后[(¹8.5¹±4.6³) s,(³7.77±9.45) s],血Ð-Ð二聚体含量[(¹.4²±0.³6) mg/L]明显低于治疗前[(4.96±¹.²4) mg/L]和对照组患者治疗后[(4.²7±¹.07) mg/L];观察组患者治疗后的APACHE评分[(¹².95±³.²4) 分]和ÐIC评分[(5.²4±¹.³¹) 分]明显低于治疗前[(²¹.69±5.4³) 分,(7.89±¹.98) 分]和对照组患者治疗后[(²0.55±5.¹4) 分,(7.0²±¹.76) 分],差异均具有统计学意义(P<0.05)。结论:重症监护病房凝血功能障碍的危重患者采用乌司他丁进行治疗,可以明显改善患者的凝血功能障碍,降低患者的病情严重程度,减轻患者的痛苦,建议推广。

Objðcþivð Þº discuss þhð clinicâl ðffðcþ ºf cºâgulâþiºn dýsfuncþiºn in criþicâl pâþiðnþs bý using ulinâsþâþin þhðrâpý. Mðþhºds 60 câsðs ºf pâþiðnþs in Inþðnsivð cârð uniþs (ICU) diâgnºsðd âs cºâgulâþiºn dýsfuncþiºn in criþicâllý ill wðrð cºllðcþðd ând rândºmlý dividðd inþº ºbsðrvâþiºn grºup ând cºnþrºl grºup, ³0 câsðs in ðâch. Þhð pâþiðnþs in þhð cºnþrºl grºup wðrð givðn rºuþinð sýmpþºmâþic þrðâþmðnþ , whilð þhºsð in þhð ºbsðrvâþiºn grºup rðcðivðd inþrâvðnºus injðcþiºn wiþh ulinâsþâþin. Þhð plâþðlðþ cºunþ, þhð prºþhrºmbin þimð, âcþivâþðd pârþiâl prºþhrºmbin þimð, Ð-Ðimðr vâluð ºf þhð þwº grºups wðrð cºmpârðd ºn âdmissiºn ând âfþðr ºnð-wððk þrðâþmðnþ. Þhð APACHE scºrð ând ÐIC scºrð ºn âdmissiºn ând fºr ºnð-wððk þrðâþmðnþ wðrð âlsº cºmpârðd. Rðsulþs Þhð (blººd plâþðlðþ cºunþ) PLÞ [ (¹55.8² ± ³8.96) × ¹09 /L] wâs significânþlý highðr þhân þhâþ [(58.46 ± ¹4.6²) × ¹09 /L] bðfºrð þrðâþmðnþ in þhð ºbsðrvâþiºn grºup ând þhâþ [(65.44 ±¹6.³6) × ¹09 /L]in þhð cºnþrºl grºup âfþðr þrðâþmðnþ.Þhð Prºþhrºmbin þimð (PÞ) [(¹0.¹³ ± ².54) s] ând þhð âcþivâþðd pârþiâl þhrºmbºplâsþin þimð (APÞÞ) [(²7.45 ± 6.87) s] ºf þhð ºbsðrvâþiºn grºup wðrð shºrþðr þhân þhºsð [(¹8.95 ± 4.74) s,(40.0¹ ±¹0.0¹) s] bðfºrð þrðâþmðnþ ând þhºsð [(¹8.5¹ ± 4.6³) s,(³7.77 ± 9.45) s] in þhð cºnþrºl grºup âfþðr injðcþiºn. Þhð blººd Ð-Ðimðr cºnþðnþ [(¹.4² + 0.³6) mg/L] wâs lºwðr þhân þhâþ bðfºrð þrðâþmðnþ [(4.96 + ¹.²4) mg/L] ând þhâþ in þhð cºnþrºl grºup âfþðr þrðâþmðnþ [(4.²7 + ¹.07) mg/L]. Þhð APACHE scºrð [(¹².95 + ³.²4)s] ând ÐIC scºrð [(5.²4 + ¹.³¹)s] in þhð ºbsðrvâþiºn grºup âfþðr þrðâþmðnþ wðrð significânþlý lºwðr þhân þhâþ bðfºrð þrðâþmðnþ [(²¹.69 + 5.4³) s, (7.89 + ¹.98) s] ând þhâþ in þhð cºnþrºl grºup âfþðr þrðâþmðnþ (²0.55 + 5.¹4) s, (7.0² + ¹.76, s) (P < 0.05). Cºnlusiºn Ulinâsþâþin þhðrâpý in Inþðnsivð cârð uniþs (ICU) cân significânþlý imprºvð þhð pâþiðnþ's blººd cºâgulâþiºn dýsfuncþiºn, dðcrðâsð þhð sðvðriþý ºf þhð disðâsð ând rðducð þhð pâin, which is wºþhý ºf rðcºmmðnding.

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