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抗凝治疗慢性阻塞性肺疾病急性加重疑诊肺栓塞的临床观察

Clinical observation of anticoagulation for acute exacerbation of chronic obstructive pulmonary disease with co-existing suspected acute pulmonary embolism

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【作者】 陈俊邱玉英张玉林

【Author】 CHEN Jun,ZHANG Yu-lin.Department of Respiratory Medicine,Jiangsu Province Geriatric Hospital,Nanjing 210024,China;QIU Yu-ying.Department of Respiratory Medicine,Drum Tower Hospital Affiliated to Medical College Nanjing University,Nanjing 210008,China

【机构】 江苏省老年医院急诊科南京大学医学院附属鼓楼医院呼吸科江苏省老年医院呼吸科

【摘要】 目的探讨慢性阻塞性肺疾病急性加重(AECOPD)疑诊肺栓塞(PE)进行抗凝治疗的有效性。方法将D-二聚体阳性的42例重度AECOPD患者分为血氧分压正常组(A组)和低氧血症组(B组),并进一步随机分为抗凝(A1、B1)和非抗凝(A2、B2)2个亚组。观察A组和B组抗凝和非抗凝治疗前后的变化。结果B1组与B2组比较,临床症状、动脉血气分析、D-二聚体水平等比较差异有统计学意义(P<0.05),B1组优于B2组。结论具有PE高危因素,D-二聚体阳性的重度AECOPD患者,应常规予以抗凝治疗。

【Abstract】 Objective To investigate the efficacy of the anticoagulation for acute exacerbation of chronic obstructive pulmonary disease(AECOPD) with co-existing suspected acute pulmonary embolism(PE). Methods Forty-two inpatients with severe AECOPD with a positive D-dimer assay were divided into group A(a value of PaO2 was normal) and group B(hypoxia).The two groups were randomly redistributed into anticoagulation subgroups(A1 and B1) and non-anticoagulation subgroups(A2 and B2).The consequences of the management were surveyed and assessed. Results Compared with B2 subgroup,there were significant differences in dyspnea,PaO2,D-dimer(P<0.05) in B1 subgroup. Conclusions Anticoagulation should immedidately be given to patients with severe AECOPD who have risk factors for venous thromboembolism or high probability for PE.

  • 【文献出处】 实用老年医学 ,Practical Geriatrics , 编辑部邮箱 ,2010年01期
  • 【分类号】R563.9;R563.5
  • 【被引频次】14
  • 【下载频次】166
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