超微剂量肝素并低分子右旋糖酐对婴幼儿重症肺炎血清D-二聚体的影响

目的观察应用超微剂量肝素并低分子右旋糖酐（低右）治疗血清D-二聚体阳性的重症肺炎患儿的疗效。方法68例患儿随机分为两组，每组各34例。肝素组应用超微剂量肝素，肝素剂量24u／（kg·d），分4次皮下注射，直至血清D-二聚体转阴停药；肝素低右组应用超微剂量肝素（剂量和用法同前），同时加用低右，用量为每次5ml／kg，每天1-2次至血清D-二聚体转阴停药。结果两组患儿在治疗的第2天，血清D-二聚体转阴率差异无统计学意义（P〉0．05），第3、4天肝素低右组患儿血清D-二聚体转阴率明显高于肝素组，两组比较差异有统计学意义（P〈0．05）。肝素低右组的病死率较肝素组低，两组分别为5．88％、17．65％。结论超微剂量肝素加小剂量低右能更快地改善血液高凝状态，逆转重症肺炎患儿的病情。

Influence of the use of Ultramicro-dosage heparin combining with low-molecule dextran on Ddimer in serum of infant patients with severe pneumonia

Objective To observe the curative effect of ultramicro-dosage heparin （UMDH）com- bining with low-molecule dextran （ LMD ）on the D-dimer positive infant with severe pneumonia. Methods Sixty-eight infant patients, whose D-dimer in serum were positive, were randomly divided into two groups with each group of 34 cases. In the heparin group, the UMDH was used with dosage of 24 U/（ kg·d ）and subcutaneous injection for 4 times. After the D-dimer in serum became negative, the drug was stopped. In the heparin combining with LMD （ HCLMD ） group, the UMDH （ same dosage as above） was used combining with the LMD. The dosage for LMD was 5 ml/kg once with general-speed intravenous drip and 1-2 times a day, which should be continued until the D-dimer in serum became negative. Results After 2-day＇s treatment, there was no obvious differences in the negative transfer rate of D-dimer between two groups （P 〉 0.05 ）. However, after 3-4 day＇s treatment, the negative transfer rate in HCLMD group was absolutely higher than that in heparin group, there were obvious differences in two groups （P 〈 0.05 ）. As for the death rate of illness, the death rate in HCLMD group was lower than that in heparin group, being respectively 5.88% and 17.65%. Conclusion The use of UMDH combining with small-dosage LMD dextran can quickly improve the high condensation situation of blood and reverse the condition of infant patients with severe pneumonia.