OBJECTIVE:To probe into the effects of low molecular weight heparin (LMWH) on microcirculation and oxygen metabolism in patients with respiratory failure of chronic obstructive pulmonary failure (COPD). METHODS:95 patients with respiratory failure of COPD admitted into Hubei Rongjun Hospital from Jul. 2015 to Jul. 2017 were selected and divided into control group (45 cases) and observation group (50 cases) via random number table. The control group was given conventional therapy, while the observation group was given LMWH combined with conventional therapy. The clinical efficacy, pulmonary function indices [maximum inspiratory pressure (MIP), maximum expiratory pressure (MEP) and total lung capacity (TLC) ], microcirculation indices and oxygen metabolism indices [arterial partial pressure of oxygen (PaO2), arterial oxygen content (CaO2) and arterial arteriovenous blood oxygen content difference (Ca-vO2) ] of two groups were observed. RESULTS:The total effective rate of observation group was 94.00％ (47/50), which was significantly higher than that of the control group (77.78％, 35/45), with statistically significant difference (P＜0.05); after treatment, the MIP, MEP and TLC levels of observation group were significantly higher than those of the control group, with statistically significant differences (P＜0.05); the capillary velocity of observation group was significantly higher than that of the control group, while the scores of blood flow state and tube loop form of observation group were significantly lower, with statistically significant differences (P＜0.05); the PaO2 and CaO2 levels of observation groups were significantly higher than those of the control group, while the Ca-vO2 level of observation groups were significantly lower, with statistically significant differences (P＜0.05). CONCLUSIONS:The efficacy of LMWH in treatment of respiratory failure of COPD is remarkable, which can effectively improve patients' microcirculation and oxygen metabolism, promote the recovery of pulmonary function.%目的:探讨低分子肝素对慢性阻塞性肺疾病呼吸衰竭患者微循环及氧代谢状态的影响.方法:选取2015年7月至2017年7月湖北省荣军医院收治的慢性阻塞性肺疾病呼吸衰竭患者95例作为研究对象,采用随机数字表法分为对照组45例和观察组50例.对照组患者给予基础治疗,观察组患者给予基础治疗+低分子肝素治疗.观察两组患者的临床疗效、肺功能指标水平[最大吸气压(MIP)、最大呼气压(MEP)及肺总量(TLC)]、微循环指标水平和氧代谢指标水平[动脉血氧分压(PaO2)、动脉血氧含量(CaO2)及动静脉血氧含量差(Ca-vO2)].结果:观察组患者的总有效率为94.00％(47/50),明显高于对照组的77.78％(35/45),差异有统计学意义(P＜0.05);治疗后,观察组患者MIP、MEP及TLC水平明显高于对照组,差异均有统计学意义(P＜0.05);观察组患者的毛细血管流速明显高于对照组,血流状态积分、管襻形态积分明显低于对照组,差异均有统计学意义(P＜0.05);观察组患者的PaO2、CaO2水平明显高于对照组,Ca-vO2水平明显低于对照组,差异均有统计学意义(P＜0.05).结论:低分子肝素治疗慢性阻塞性肺疾病呼吸衰竭的疗效较好,可有效改善患者微循环及氧代谢,促进患者肺功能恢复.
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