重症感染患者早期应用小剂量肝素治疗的临床研究

目的观察早期小剂量肝素治疗重症感染患者的疗效。方法重症感染成年患者22例,随机分为两组：实验组和对照组。对照组行常规ICU治疗,实验组除常规治疗外,早期应用小剂量肝素。在入ICU后每日检测记录患者凝血酶原时间（PT）、活化部分凝血活酶时间（APTT）、血小板计数、APACHEⅡ评分、入ICU的时间、住院时间、治愈率、28d生存率。结果治疗后实验组胛、APTT改善,对照组PT,APTT无明显变化,两组间血小板变化无差异;实验组入ICU的时间明显少于对照组（P〈0．01）;实验组治愈率（81．8％）明显高于对照组（54．5％）;实验组住院时间和28d生存率与对照组之间无显著差异（P〉0．05）。结论早期小剂量肝素治疗可改善重症感染患者的凝血指标,减少患者在ICU的住院时间,提高其治愈率,但未能改善生存率。

Therapeutic effects of early administration of low-dose heparin in patients with severe sepsis

OBJECTIVE: To study the therapeutic effects of early administration of low-dose heparin in patients with severe sepsis. METHODS: Twenty-two patients were randomly divided into experimental group and control group. In addition to the routine treatment, the patients in experimental group were given low-dose heparin, while those in control group were not. Prothrombin time (PT), activated partial thromboplastin time (APTT), platelet count, APACHE II score, ICU days, hospital days, cure rate, and 28-day survival rate were investigated in the two groups. RESULTS: After the treatment, PT and APTT recovered normal in the experimental group, but remained abnormal in the control group. There was no significant difference in platelet count between the two groups. ICU days in experimental group was shorter than that in control group (P < 0.01). Cure rate in experimental group was 81.8%, which was significantly higher than that in control group (54.5%). There was no significant difference in hospital days and 28-day survival rate between the two groups. CONCLUSIONS: Early administration of low-dose heparin therapy can improve coagulative function in patients with severe sepsis, however, the survival rate was not improved.