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Low-molecular-weight heparin and preeclampsia—does the sword cut both ways?Three case reports and review of literature
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作者 Dan Shan Tao Li +1 位作者 Xi Tan Ya-Yi Hu 《World Journal of Clinical Cases》 SCIE 2024年第9期1634-1643,共10页
BACKGROUND Low-molecular-weight heparins(LMWH)are the most commonly used anticoagulants during pregnancy.It is considered to be the drug of choice due to its safety in not crossing placenta.Considering the beneficial ... BACKGROUND Low-molecular-weight heparins(LMWH)are the most commonly used anticoagulants during pregnancy.It is considered to be the drug of choice due to its safety in not crossing placenta.Considering the beneficial effect in the improvement of microcirculation,prophylactic application of LMWH in patients with preeclampsia became a trend.However,the bleeding risk related with LMWH in preeclampsia patients has seldomly been evaluated.This current study aimed to identify the potential risks regarding LMWH application in patients with preeclampsia.CASE SUMMARY Herein we present a case series of three pregnant women diagnosed with preeclampsia on LMWH therapy during pregnancy.All the cases experienced catastrophic hemorrhagic events.After reviewing the twenty-one meta-analyses,the bleeding risk related with LMWH seems ignorable.Only one study analyzed the bleeding risk of LMWH and found a significantly higher risk of developing PPH in women receiving LMWH.Other studies reported minor bleeding risks,none of these were serious enough to stop LMWH treatment.Possibilities of bleeding either from uterus or from intrabdominal organs in preeclampsia patients on LMWH therapy should not be ignored.Intensive management of blood pressure even after delivery and homeostasis suture in surgery are crucial.CONCLUSION Consideration should be given to the balance between benefits and risks of LMWH in patients with preeclampsia. 展开更多
关键词 PREGNANCY PREECLAMPSIA low-molecular-weight heparin HEMORRHAGE Case report
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Clinical effectiveness of a pneumatic compression device combined with low-molecular-weight heparin for the prevention of deep vein thrombosis in trauma patients:A single-center retrospective cohort study 被引量:4
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作者 Peng-chao Guo Nan Li +1 位作者 Hui-ming Zhong Guang-feng Zhao 《World Journal of Emergency Medicine》 SCIE CAS CSCD 2022年第3期189-195,共7页
BACKGROUND:To investigate the clinical effectiveness of a pneumatic compression device(PCD)combined with low-molecular-weight heparin(LMWH)for the prevention and treatment of deep vein thrombosis(DVT)in trauma patient... BACKGROUND:To investigate the clinical effectiveness of a pneumatic compression device(PCD)combined with low-molecular-weight heparin(LMWH)for the prevention and treatment of deep vein thrombosis(DVT)in trauma patients.METHODS:This study retrospectively analyzed 286 patients with mild craniocerebral injury and clavicular fractures admitted to our department from January 2016 to February 2020.Patients treated with only LMWH served as the control group,and patients treated with a PCD combined with LMWH as the observation group.The incidence of DVT,postoperative changes in the visual analogue scale(VAS)score,and coagulation function were observed and compared between the two groups.Excluding the influence of other single factors,binary logistic regression analysis was used to evaluate the use of a PCD in the patient’s postoperative coagulation function.RESULTS:After excluding 34 patients who did not meet the inclusion criteria,252 patients were were included.The incidence of DVT in the observation group was significantly lower than that in the control group(5.6%vs.15.1%,χ^(2)=4.605,P<0.05).The postoperative VAS scores of the two groups were lower than those before surgery(P<0.05).The coagulation function of the observation group was significantly higher than that of the control group,with a better combined anticoagulant effect(P<0.05).There were no significant differences between the two groups in preoperative or postoperative Glasgow Coma Scale scores,intraoperative blood loss,postoperative infection rate,or length of hospital stay(P>0.05).According to logistic regression analysis,the postoperative risk of DVT in patients who received LMWH alone was 1.764 times that of patients who received LMWH+PCD(P<0.05).The area under the receiver operating characteristic(AUROC)curve of partial thromboplastin time(APTT)and platelet(PLT)were greater than 0.5,indicating that they were the influence indicators of adding PCD to prevent DVT.Excluding the influence of other variables,LMWH+PCD effectively improved the coagulation function of patients.CONCLUSIONS:Compared with LMWH alone,LMWH+PCD could improve blood rheology and coagulation function in patients with traumatic brain injury and clavicular fracture,reduce the incidence of DVT,shorten the length of hospital stay,and improve the clinical effectiveness of treatment. 展开更多
关键词 Deep vein thrombosis Pneumatic compression device low-molecular-weight heparin TRAUMA Logistic regression analysis
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Incidence of pocket hematoma after electrophysiological device placement:dual antiplatelet therapy versus low-molecular-weight heparin regimen 被引量:3
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作者 Yan CHEN Yun-Tao LI +8 位作者 Ming-Dong GAO Ze-Chun ZENG Jin-Rong ZHANG Hong-Liang CONG Yin LIU Ru ZHAO Le-Feng WANG Xin-Cun YANG Kang MENG 《Journal of Geriatric Cardiology》 SCIE CAS CSCD 2014年第3期200-205,共6页
Background Given the increasing number of patients who require dual antiplatelet (DAP) therapy and electrophysiological device (EPD) placement, perioperative antiplatelet management is a current challenge. In this... Background Given the increasing number of patients who require dual antiplatelet (DAP) therapy and electrophysiological device (EPD) placement, perioperative antiplatelet management is a current challenge. In this study, we investigated the incidence of pocket hema-toma formation after EPD placement in patients undergoing DAP therapy or an alternative low-molecular-weight heparin (LMWH) regimen. Methods This clinical observational study was performed from July 2010 to July 2012. In total, 171 patients were enrolled in the analysis after meeting the inclusion criteria. These patients were divided into two groups: 86 patients were treated with DAP therapy at the time of device implantation, and the DAP therapy was discontinued for 5 to 7 days and replaced with enoxaparin before device implantation in the other 85 patients. Adenosine phosphate (ADP)-mediated platelet aggregation and arachidonic acid-induced platelet aggregation were tested preoperatively. We compared the incidence of pocket hematoma between the two groups and the association of pocket hematoma develop-ment with ADP-mediated platelet aggregation and arachidonic acid-induced platelet aggregation.Results The incidence of pocket hema-toma in the patients who continued DAP was lower than that in the patients who replaced the dual antiplatelet regimen with LMWH (3.49%vs. 16.47%, respectively;X2 = 6.66,P 〈 0.01). Among the patients who continued DAP therapies, the rate of ADP-mediated platelet aggre-gation inhibition in patients with pocket hematomas was higher than that in patients without pocket hematomas. None of the patients under-going DAP or enoxaparin therapy developed pocket infection, thromboembolic events, or other serious complications. Multiple logistic re-gression analysis revealed that LMWH therapy was an independent risk factor for the development of pocket hematoma (RR = 0.054, 95%CI = 0.012-0.251). Furthermore, patients undergoing LMWH therapy were 5.1-fold more likely to develop pocket hematomas than were DAP-treated individuals.Conclusion Continuance of DAP therapy does not increase the risk of pocket hematoma formation after EPD placement. 展开更多
关键词 Antiplatelet drug Hematoma low-molecular-weight heparin Electrophysiological device
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Heparin Sodium Was Prepared from Pig Intestinal Mucosa by Dialysis and Spray Drying
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作者 Shunshun Shu Qian Mi +3 位作者 Caixia Yang Chonghuan Bao Zhaoyang Wang Jun Niu 《Journal of Biosciences and Medicines》 2018年第10期5-11,共7页
A method to extract crude heparin sodium from pig intestinal mucosa by dialysis and spray drying was established. The pig intestinal mucosa was treated in the following steps: enzymolysis, resin exchange adsorption-wa... A method to extract crude heparin sodium from pig intestinal mucosa by dialysis and spray drying was established. The pig intestinal mucosa was treated in the following steps: enzymolysis, resin exchange adsorption-washing, elution, pressure filtration, dialysis, spray drying. Activity of the product was measured using a heparin anti-IIa factor assay kit. The yield of crude heparin obtained by this method was 2.79% higher than that of oven drying method;the production of 1 kg crude heparin sodium saved 43.4 pigs small intestine. The activity was 98.48 ± 2.49 IU/mg (n = 5), 15.18 IU/mg higher than that obtained by oven drying method. The product is pale white powder, attractive color and easy to dissolve. 展开更多
关键词 heparin sodium DIALYSIS and Spray DRYING OVEN DRYING Method The Production Process
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Segregation Treatment and Resource Recycling of Enteric Coating and Heparin Sodium Manufacturing Wastewater
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作者 Jiang Chunhua Zhai Jian +3 位作者 Cao Guoqing Lu Xiuguo Ling Shulei Zhang Jing 《Meteorological and Environmental Research》 CAS 2014年第4期51-53,共3页
Firstly, the water-quality characteristics of intestinal lavage wastewater and enzymolysis wastewater from the typical heparin sodium pro- ductive process were analyzed, and then the segregation treatment was applied ... Firstly, the water-quality characteristics of intestinal lavage wastewater and enzymolysis wastewater from the typical heparin sodium pro- ductive process were analyzed, and then the segregation treatment was applied in the treatment of enteric coating and heparin sodium manufacturing wastewater. Finally, the treatment of the two kinds of wastewater by different methods were discussed. The results showed that, COD of enzymolysis wastewater treated by centrifugation-coagulation-Fenton reagent oxidation-adsorption process was lower than 100 mg/L, while intestinal lavage wastewater treated by coagulation-ASBR-SBR process could meet the first standard of Comprehensive Discharge Standard of Sewage (GB8978-1996) after one month of continuous operation. 展开更多
关键词 Enteric coating and heparin sodium manufacturing wastewater Segregation treatment Resource recovery technology ASBR-SBR Fenton reagent China
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Impact of Pharmaceutical Care on Self-Administration of Outpatient Low-Molecular-Weight Heparin Therapy
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作者 Seraina Mengiardi Dimitrios A. Tsakiris +4 位作者 Viviane Molnar Urs Kohlhaas-Styk Michael Mittag Stephan Kraehenbuehl Kurt E. Hersberger 《Pharmacology & Pharmacy》 2014年第4期372-385,共14页
Outpatient subcutaneous (s.c.) therapies are becoming more and more common in the treatment of different diseases. The effectiveness of community-pharmacy-based interventions in preventing problems that arise during s... Outpatient subcutaneous (s.c.) therapies are becoming more and more common in the treatment of different diseases. The effectiveness of community-pharmacy-based interventions in preventing problems that arise during s.c. self-injections of low-molecular-weight heparins (LMWH) is unknown. Our objective was to provide a standard operating procedure (SOP) for community pharmacists and to compare pharmaceutical vs. standard care in both clinical and daily life settings. We hypothesized that: pharmaceutical care results in improved adherence, safety, and satisfaction, and in fewer complications;the interventions used are feasible in daily life;and the results achieved in clinical and daily life settings are comparable. In the clinical setting (randomized controlled trial), patients were recruited sequentially in hospital wards;in the daily life setting (quasi-experimental design with a comparison group), recruitment took place in community pharmacies by pharmacists and trained master students during their internship. Interventions were offered according to patient needs. Data were collected by means of a monitored self-injection at home and structured questionnaire-based telephone interviews at the beginning and the end of the LMWH treatment. The main outcome measures were: scores to assess patient’s skills;syringe count to assess adherence;and frequency, effectiveness, and patient’s assessment of received interventions. The results show a median age of the 139 patients of 54 years. Interventions resulted in improved application quality (p p = 0.03). Oral instructions were pivotal for improving patients’ application quality. We found no significant score differences between the intervention groups in the clinical and daily life settings. Patients’ baseline skills were high, with the lowest score being 0.86 (score range ?2.00 to +2.00). Adherence rate was high (95.8%). In conclusion, our SOP for pharmacist interventions was of good quality, adequate, appreciated, and feasible in daily life. Patients are capable of managing s.c. injection therapies if adequate assistance is provided. 展开更多
关键词 low-molecular-weight heparin OUTPATIENTS SUBCUTANEOUS Injections Self Administration Pharmaceutical Care Community PHARMACY Switzerland
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Evaluation of a Dose-Monitoring Method for Prophylactic Anticoagulant Therapy with Low-Molecular-Weight Heparin
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作者 Shintaro Makino Motoi Sugimura +3 位作者 Takashi Yorifuji Taro Koshiishi Toshitaka Tanaka Satoru Takeda 《International Journal of Clinical Medicine》 2011年第4期429-434,共6页
Objective: In the present study, we report on the results of our investigation of optimum dose monitoring using coagulation and fibrinolytic system indicators during obstetric prophylactic anticoagulant therapy with e... Objective: In the present study, we report on the results of our investigation of optimum dose monitoring using coagulation and fibrinolytic system indicators during obstetric prophylactic anticoagulant therapy with enoxaparin. Study Design: Of 103 cases of cesarean section performed at our hospital, 37 cases were selected for this study after obtain ing their consent for blood collection. Variables of the coagulation and fibrinolytic systems [anti-factor Xa activity, endogenous thrombin potential (ETP), prothrombin time (PT) or international normalized ratio (INR), activated partial thromboplastin time (APTT) and D-dimer levels] were determined. Results: In the 5-day administration group, the anti-factor Xa activitywas 0.0 U/ml on the postoperative day 1, increased to 0.05 U/ml ± 0.04 U/ml on the postoperative day 3, and mildly increased to 0.06 U/ml ± 0.05 U/ml on the postoperative day 5. On the other hand, the anti-factor Xa activity in the 3-day administration group was 0.0 U/ml on the postoperative day 1 (before enoxaparin administration), increased to 0.06 U/ml ± 0.05 U/ml on the postoperative day 3, and significantly decreased to 0.02 U/ml ± 0.03 U/ml on the postoperative day 5 (p = 0.003);thus, the pattern of change was significantly different from that in the 5-day administration group (p = 0.004). Enoxaparin administration did not result in any significant fluctuation of the ETP, and no significant difference was observed between the 5-day and 3-day administration groups. Conclusion: Enoxaparin administration was associated with increase of the anti-factor Xa activity, and prolonged administration led to more sustained increase of the activity. 展开更多
关键词 CESAREAN Section PROPHYLACTIC ANTICOAGULANT Therapy low-molecular-weight heparin Anti-factor Xa Activity Endogenous THROMBIN Potentialintroduction
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Effect of adjuvant low-molecular-weight heparin therapy on placental hypoxia and cell apoptosis in puerperae with severe preeclampsia
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作者 Miao Zhou Rong-Ying Ou 《Journal of Hainan Medical University》 2017年第8期89-93,共5页
Objective:To study the effect of adjuvant low-molecular-weight heparin therapy on placental hypoxia and cell apoptosis in puerperae with severe preeclampsia.Methods:A total of 94 puerperae with severe preeclampsia who... Objective:To study the effect of adjuvant low-molecular-weight heparin therapy on placental hypoxia and cell apoptosis in puerperae with severe preeclampsia.Methods:A total of 94 puerperae with severe preeclampsia who received treatment and safely gave birth in our hospital between May 2014 and May 2016 were selected as the research subjects and randomly divided into the LMWH group who received low-molecular-weight heparin combined with conventional symptomatic treatment and the control group who received conventional symptomatic treatment. Before and after treatment, serum was collected respectively to determine the levels of placental hypoxia-related cytokines, and after delivery, the placentas were collected to detect oxidative stress indexes and cell apoptosis indexes.Results: After treatment, serum PLGF and PAPP-A levels of both groups were significantly higher than those before treatment while sFlt-1 and sEng levels were significantly lower than those before treatment, and after treatment, serum PLGF and PAPP-A levels of LMWH group were significantly higher than those of control group while sFlt-1 and sEng levels were significantly lower than those of control group;ROS and RNS levels as well as Fas, FasL, caspase-3 and caspase-8 protein expression in placenta tissue of LMWH group were significantly lower than those of control group while GPx-1, SOD-1 and Trx levels as well as Survivin, XIAP and Bcl-2 protein expression were significantly higher than those of control group.Conclusion:Adjuvant low-molecular-weight heparin therapy can relieve the placental hypoxia, improve oxidative stress reaction and inhibit cell apoptosis in puerperae with severe preeclampsia. 展开更多
关键词 Severe PREECLAMPSIA low-molecular-weight heparin Oxidative stress Apoptosis
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Rivaroxaban for the treatment of heparin-induced thrombocytopenia with thrombosis in a patient undergoing artificial hip arthroplasty:A case report
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作者 Fang-Fang Lv Mei-Ye Li +1 位作者 Wei Qu Zhao-Shun Jiang 《World Journal of Clinical Cases》 SCIE 2023年第26期6147-6153,共7页
BACKGROUND Anticoagulation treatment after lower limb surgery is one of the key methods to avoid thrombosis,and low-molecular-weight heparin is the treatment that is most frequently used in clinical practice.But one u... BACKGROUND Anticoagulation treatment after lower limb surgery is one of the key methods to avoid thrombosis,and low-molecular-weight heparin is the treatment that is most frequently used in clinical practice.But one uncommon side effect of lowmolecular-weight heparin is heparin-induced thrombocytopenia(HIT),which can develop into thrombosis if not caught early or managed incorrectly.CASE SUMMARY We present a case of a patient who underwent hip arthroplasty and experienced thrombocytopenia due to HIT on the 9th d following the application of lowmolecular-weight heparin anticoagulation.We did not diagnose HIT in time and applied 1 unit of platelets to the patient,which led to thrombosis.Luckily,the patient recovered following effective and timely surgery and treatment with rivaroxaban.CONCLUSION Patients using low-molecular-weight heparin after lower limb surgery need to have their platelet counts regularly checked.If HIT develops,platelet treatment should be given with caution. 展开更多
关键词 low-molecular-weight heparin heparin-induced thrombocytopenia with thrombosis PLATELET Case report
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小剂量肝素钠与低分子肝素钙对脓毒症治疗作用的对比研究 被引量:1
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作者 温亚 白思怡 《临床医药实践》 2024年第2期141-143,147,共4页
目的:对比小剂量肝素钠与低分子肝素钙治疗脓毒症的效果。方法:选取2021年10月—2022年10月脓毒症患者100例,随机分为观察组和对照组,每组50例。对比两组患者的治疗效果。结果:对照组弥散性血管内凝血8例(16.0%),观察组弥散性血管内凝血... 目的:对比小剂量肝素钠与低分子肝素钙治疗脓毒症的效果。方法:选取2021年10月—2022年10月脓毒症患者100例,随机分为观察组和对照组,每组50例。对比两组患者的治疗效果。结果:对照组弥散性血管内凝血8例(16.0%),观察组弥散性血管内凝血1例(2.0%),观察组临床疗效高于对照组(P<0.05)。随访1个月,观察组病死率低于对照组(P<0.05)。观察组各项凝血指标显著优于对照组(P<0.05)。观察组各项炎性因子水平低于对照组(P<0.05)。两组治疗后急性生理与健康评分(APACHEⅡ)优于治疗前,且观察组优于对照组,差异有统计学意义(P<0.05)。结论:低分子肝素钙相比小剂量肝素钠治疗脓毒症更加可行,可降低并发症发生率,改善短期预后。 展开更多
关键词 脓毒症 小剂量肝素钠 低分子肝素钙 凝血系统 弥散性血管内凝血
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PDCA在降低患者自行注射预灌式低分子肝素钠皮下瘀斑发生率中的应用效果
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作者 张玉珍 黄艳慧 吴荣锋 《中国卫生标准管理》 2024年第20期189-193,共5页
目的探讨开展计划-实施-检查-处理(plan-do-check-act,PDCA)循环在降低患者自行注射预灌式低分子肝素钠皮下瘀斑发生率中的应用效果。方法将2023年3—5月在厦门大学附属第一医院就诊并自行注射预灌式低分子肝素钠的56例患者作为对照组,... 目的探讨开展计划-实施-检查-处理(plan-do-check-act,PDCA)循环在降低患者自行注射预灌式低分子肝素钠皮下瘀斑发生率中的应用效果。方法将2023年3—5月在厦门大学附属第一医院就诊并自行注射预灌式低分子肝素钠的56例患者作为对照组,将2023年8—10月自行注射预灌式低分子肝素钠的49例患者作为观察组。对照组采用常规注射流程进行注射指导,观察组运用PDCA循环工具进行注射干预管理。比较2组自行注射预灌式低分子肝素钠皮下瘀斑的发生率。结果观察组注射部位未轮换发生率为20.4%,未带空气泡注射发生率为18.4%,按压手法不准确发生率为16.3%,进针深度不准确发生率为6.1%,按压时间不够发生率为4.1%,低于对照组的44.6%、39.3%、35.7%、19.6%、17.9%,差异有统计学意义(P<0.05)。观察组注射时疼痛程度优于对照组,差异有统计学意义(P<0.05)。观察组皮下瘀斑的发生率为12.2%,低于对照组的33.9%,差异有统计学意义(P<0.05)。结论PDCA循环工具的应用有助于降低患者自行注射预灌式低分子肝素钠皮下瘀斑的发生率。 展开更多
关键词 PDCA 降低 自行注射 预灌式低分子肝素钠 皮下瘀斑 发生率
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肝素钠注射液皮下注射知信行现状调查研究
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作者 姚晚侠 李英 +6 位作者 陈静 王静 蔡红 吕蒙蒙 卫钰 马卫平 张飒乐 《安徽医药》 CAS 2024年第4期839-844,共6页
目的 调查肝素钠注射液皮下注射护理操作规范的知信行现状及其影响因素,为临床护士的培训及管理提供参考依据。方法 使用方便抽样法选取2022年4-5月西安交通大学第一附属医院、西北妇女儿童医院和深圳市人民医院临床护士720人为研究对象... 目的 调查肝素钠注射液皮下注射护理操作规范的知信行现状及其影响因素,为临床护士的培训及管理提供参考依据。方法 使用方便抽样法选取2022年4-5月西安交通大学第一附属医院、西北妇女儿童医院和深圳市人民医院临床护士720人为研究对象,采用临床护士肝素钠注射液皮下注射护理操作规范的知信行调查问卷,进行问卷调查并寻找其影响因素。结果 临床护士肝素钠注射液皮下注射知信行得分(145.33±19.94)分,知识、态度、行为三维度分别是(19.23±4.48)分、(44.33±6.82)分、(81.73±15.05)分;多元线性回归结果显示临床护士对肝素钠注射液皮下注射操作知识的显著影响因素是工作时长、有无接受肝素钠注射液皮下注射操作培训;态度的显著影响因素是工作时长;行为的显著影响因素是知识、态度及有无接受肝素钠注射液皮下注射培训等。结论 临床护士关于肝素钠注射液皮下注射操作护理态度积极程度较好,但知识水平和行为执行情况有待进一步促进和提高。管理者只有采取多样化形式培训,做好肝素钠注射液皮下注射的质控管理,才能确保病人的用药安全。 展开更多
关键词 肝素钠 皮下注射 知信行 研究 培训
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低分子肝素钠联合小剂量黄体酮治疗先兆流产临床效果及对妊娠结局的影响
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作者 傅旭峰 曹晔 《实用妇科内分泌电子杂志》 2024年第2期54-56,共3页
目的探究低分子肝素钠联合小剂量黄体酮治疗先兆流产的临床效果及对妊娠结局的影响。方法选取90例先兆流产产妇,根据治疗方法不同分为研究组(50例)与对照组(40例)。对照组采用小剂量黄体酮治疗,研究组在对照组基础上联合低分子肝素钠治... 目的探究低分子肝素钠联合小剂量黄体酮治疗先兆流产的临床效果及对妊娠结局的影响。方法选取90例先兆流产产妇,根据治疗方法不同分为研究组(50例)与对照组(40例)。对照组采用小剂量黄体酮治疗,研究组在对照组基础上联合低分子肝素钠治疗。比较两组临床疗效、血栓前状态标志物水平及妊娠结局。结果研究组治疗总有效率(94.00%)高于对照组(80.00%)(P<0.05)。研究组足月妊娠率高于对照组,流产率低于对照组(P<0.05),两组早产率比较差异无统计学意义(P>0.05)。研究组治疗后纤维蛋白溶酶原(PLG)水平高于对照组,蛋白C(PC)水平低于对照组(P<0.05)。结论低分子肝素钠联合小剂量黄体酮治疗先兆流产产妇,可以调节血栓前状态标志物水平,提高临床疗效,改善妊娠结局,值得临床推广。 展开更多
关键词 低分子肝素钠 先兆流产 妊娠结局 黄体酮
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低分子肝素钠辅助连续性静脉-静脉血液滤过治疗重症脓毒症患者的临床效果
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作者 王宁 《中外医药研究》 2024年第22期45-47,共3页
目的:探讨低分子肝素钠辅助连续性静脉-静脉血液滤过(CVVH)治疗重症脓毒症的临床效果。方法:选取2022年1月-2023年6月浙江大学医学院附属第二医院收治的84例行CVVH治疗的重症脓毒症患者为研究对象,采用随机数字表法分为对照组和试验组,... 目的:探讨低分子肝素钠辅助连续性静脉-静脉血液滤过(CVVH)治疗重症脓毒症的临床效果。方法:选取2022年1月-2023年6月浙江大学医学院附属第二医院收治的84例行CVVH治疗的重症脓毒症患者为研究对象,采用随机数字表法分为对照组和试验组,各42例。对照组采用肝素钠注射液抗凝辅助治疗,试验组采用低分子肝素钠抗凝辅助治疗。比较两组凝血指标、序贯性器官功能衰竭(SOFA)评分、急性生理和慢性健康状况评分Ⅱ(APACHEⅡ)评分、炎性因子水平、不良事件发生率。结果:治疗后,两组活化部分凝血活酶时间、凝血酶时间、凝血酶原时间低于治疗前,血小板计数高于治疗前,试验组优于对照组,差异有统计学意义(P<0.05);治疗后,两组SOFA、APACHEⅡ评分低于治疗前,试验组SOFA、APACHEⅡ评分低于对照组,差异有统计学意义(P<0.05);治疗后,两组肿瘤坏死因子-α、超敏C反应蛋白水平低于治疗前,试验组低于对照组,差异有统计学意义(P<0.05);两组不良事件发生率比较,差异无统计学意义(P>0.05)。结论:低分子肝素钠辅助CVVH治疗重症脓毒症患者可有效改善凝血功能,缓解炎性反应及临床症状,安全性高。 展开更多
关键词 低分子肝素钠 脓毒症 肝素钠
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参芪寿胎丸联合黄体酮、低分子肝素钠治疗肾虚血瘀型复发性流产患者的临床效果及对血栓弹力图的影响
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作者 石英 《妇儿健康导刊》 2024年第22期59-63,共5页
目的观察参芪寿胎丸联合黄体酮、低分子肝素钠治疗肾虚血瘀型复发性流产患者的临床效果及对血栓弹力图(TEG)的影响。方法选取2021年1月至2023年6月在莱州市人民医院保胎的复发性流产患者90例,按照随机数字表法分为研究组和对照组,每组4... 目的观察参芪寿胎丸联合黄体酮、低分子肝素钠治疗肾虚血瘀型复发性流产患者的临床效果及对血栓弹力图(TEG)的影响。方法选取2021年1月至2023年6月在莱州市人民医院保胎的复发性流产患者90例,按照随机数字表法分为研究组和对照组,每组45例。对照组治疗以黄体酮+低分子肝素钠为主,研究组在此基础上予以参芪寿胎丸治疗,分析两组患者治疗前后中医证候评分、TEG指标、激素水平以及保胎成功率。结果治疗后研究组中医证候积分低于对照组,TEG指标最大振幅、反应时间、凝血综合指数优于对照组,雌二醇、孕酮、β绒毛膜促性腺激素水平高于对照组,保胎成功率为86.67%,高于对照组的66.67%,差异均有统计学意义(P<0.05)。结论参芪寿胎丸联合黄体酮、低分子肝素钠不仅能够提升肾虚血瘀型复发性流产患者保胎成功率、改善临床症状,还能够明显改善患者凝血水平,具有很好的临床应用价值。 展开更多
关键词 参芪寿胎丸 低分子肝素钠 肾虚血瘀复发性流产 血栓弹力图
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低分子肝素钙/磺达肝癸钠序贯联合双嘧达莫预防性抗凝在肾病综合征中的应用效果及安全性
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作者 鄢成静 孙艳 +2 位作者 冷彦飞 周芸 袁飞远 《临床和实验医学杂志》 2024年第6期577-581,共5页
目的探讨低分子肝素钙/磺达肝癸钠序贯联合双嘧达莫预防性抗凝在原发性肾病综合征(PNS)中的应用效果及安全性。方法回顾性选取2020年3月至2022年12月期间四川省凉山彝族自治州第一人民医院收治的188例PNS患者,根据肾穿刺活检病理结果及... 目的探讨低分子肝素钙/磺达肝癸钠序贯联合双嘧达莫预防性抗凝在原发性肾病综合征(PNS)中的应用效果及安全性。方法回顾性选取2020年3月至2022年12月期间四川省凉山彝族自治州第一人民医院收治的188例PNS患者,根据肾穿刺活检病理结果及磷脂酶A2受体抗体分为膜性肾病组(n=73)与非膜性肾病组(n=115)。两组患者均根据血清白蛋白水平,采用低分子肝素钙或磺达肝癸钠序贯联合双嘧达莫抗凝。比较两组患者治疗前及治疗后4周、治疗后6个月的肾功能指标[白蛋白、尿素氮、血肌酐、肾小球滤过率(eGFR)和24 h尿蛋白定量(24 h PRO)],治疗前及治疗后4周的血栓弹力图指标[反应指数(R时间)、凝血时间(K时间)、血栓最大弹力度(MA)、凝血指数(CI)和α角],以及随访6个月记录血栓事件、出血事件。结果治疗后4周、6个月,两组的白蛋白、eGFR均较治疗前明显升高,尿素氮、血肌酐、24 h PRO均较治疗前明显降低,差异均有统计学意义(P<0.05),但两组治疗后各肾功能指标比较,差异均无统计学意义(P>0.05)。治疗后4周,两组患者的R时间、K时间均较治疗前明显延长,MA、CI值和α角均较治疗前明显降低,差异均有统计学意义(P<0.05),但两组患者治疗后4周的R时间、K时间、MA、CI值和α角比较,差异均无统计学意义(P>0.05)。膜性肾病组患者的血栓、出血事件发生率分别为6.85%、10.96%,均高于非膜性肾病组(0.87%、3.48%),但两组间血栓事件总发生率、出血事件发生率比较,差异均无统计学意义(P>0.05)。结论低分子肝素钙/磺达肝癸钠序贯联合双嘧达莫预防性抗凝有利于改善PNS患者的肾功能,缓解高凝状态,降低血栓栓塞事件发生率,且非膜性肾病患者获益较膜性肾病患者更明显,安全性更高。 展开更多
关键词 肾病综合征 膜性肾病 非膜性肾病 低分子肝素钙 磺达肝癸钠 双嘧达莫 预防性抗凝
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甲磺酸萘莫司他在高出血风险患者连续性血液净化中的抗凝应用效果观察
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作者 卢文婷 向淑麟 +4 位作者 任彦文 胡琨琳 庞静 莫丽 熊滨 《中国临床新医学》 2024年第1期74-78,共5页
目的 观察甲磺酸萘莫司他(NM)在高出血风险患者连续性血液净化(CBP)中的抗凝应用效果。方法 回顾性收集2023年1月至3月广西壮族自治区人民医院重症医学科收治的34例需要进行CBP的有高出血风险重症患者的临床资料,根据抗凝剂使用情况将... 目的 观察甲磺酸萘莫司他(NM)在高出血风险患者连续性血液净化(CBP)中的抗凝应用效果。方法 回顾性收集2023年1月至3月广西壮族自治区人民医院重症医学科收治的34例需要进行CBP的有高出血风险重症患者的临床资料,根据抗凝剂使用情况将其分为NM组(10例)、枸橼酸钠组(10例)和低分子量肝素组(14例)。比较三组滤器寿命以及临床显著出血事件和其他不良事件发生情况。结果 NM组、枸橼酸钠组和低分子量肝素组的滤器寿命分别为40.00(17.00,51.00)h、36.00(22.00,60.00)h和51.00(45.00,61.50)h,三组比较差异无统计学意义(H=2.096,P=0.351)。在抗凝过程中,NM组无临床显著出血事件发生,枸橼酸钠组和低分子量肝素组分别有3例(30.00%)和4例(28.57%)患者发生临床显著出血事件,三组临床显著出血事件发生率比较差异有统计学意义(χ^(2)=14.171,P=0.001)。低分子量肝素组发生继发性血小板减少6例。NM组未发生过敏反应、高钾血症和粒细胞缺乏症等NM输注相关的不良反应。枸橼酸钠组未发生枸橼酸蓄积、枸橼酸中毒等不良反应。三组患者均未观察到血栓栓塞事件。结论 NM的抗凝效果与枸橼酸钠、低分子量肝素抗凝效果相当,且临床显著出血事件发生率更低,在高出血风险患者中应用的安全性良好。 展开更多
关键词 甲磺酸萘莫司他 枸橼酸钠抗凝剂 低分子量肝素 连续性血液净化 滤器寿命 出血
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离子色谱法同时测定低分子量肝素钠注射液中的有机酸和无机阴离子
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作者 肖菁 王蓉蓉 +4 位作者 张俊 谢莹莹 李子珊 黄舒 姚静 《中南药学》 CAS 2024年第8期2187-2190,共4页
目的建立同时测定低分子量肝素钠注射液中醋酸根离子、氯离子、亚硫酸根离子、硫酸根离子和草酸根离子含量的离子色谱法。方法色谱柱为Dionex IonPac AS11(250 mm×4 mm),保护柱为Dionex IonPac AG11(50 mm×4 mm),用淋洗液自... 目的建立同时测定低分子量肝素钠注射液中醋酸根离子、氯离子、亚硫酸根离子、硫酸根离子和草酸根离子含量的离子色谱法。方法色谱柱为Dionex IonPac AS11(250 mm×4 mm),保护柱为Dionex IonPac AG11(50 mm×4 mm),用淋洗液自动发生器,采用氢氧化钾梯度洗脱,流速为1.0 mL·min^(-1),检测器为配有化学抑制器的电导检测器。结果醋酸根离子、氯离子、亚硫酸根离子、硫酸根离子和草酸根离子分别在0.12~24μg·mL^(-1)、0.24~48μg·mL^(-1)、0.4~80μg·mL^(-1)、0.04~8μg·mL^(-1)、0.3~60μg·mL^(-1)与测定值线性关系良好,r分别为0.9991、0.9999、0.9999、0.9995、0.9995;加样回收率分别为105.3%、101.0%、102.3%、96.8%和108.3%(n=6),RSD分别为2.2%、1.8%、1.6%、2.6%和1.6%。结论该方法操作简便,灵敏,高效,可用于同时测定低分子量肝素钠注射液中醋酸根、亚硫酸根、硫酸根、草酸根和氯离子的含量,为其质量提供保证。 展开更多
关键词 离子色谱法 低分子量肝素钠注射液 醋酸根离子 氯离子 亚硫酸根离子 硫酸根离子 草酸根离子
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低分子肝素钠联合阿司匹林治疗复发性流产的临床疗效分析 被引量:2
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作者 刘昕媛 《罕少疾病杂志》 2024年第5期78-80,共3页
目的探讨低分子肝素钠联合阿司匹林治疗复发性流产的疗效。方法将2020年6月-2022年6月河南省洛阳市妇幼保健院生殖医学科就诊的200例复发性流产患者纳入研究,对照组患者皮下注射4000 IU低分子量肝素钠进行治疗,1次/d;观察组患者在对照... 目的探讨低分子肝素钠联合阿司匹林治疗复发性流产的疗效。方法将2020年6月-2022年6月河南省洛阳市妇幼保健院生殖医学科就诊的200例复发性流产患者纳入研究,对照组患者皮下注射4000 IU低分子量肝素钠进行治疗,1次/d;观察组患者在对照组基础上,联合口服75mg阿司匹林肠溶片进行治疗,1次/d。两组患者均从孕5周开始用药,持续至孕12周。比较两组患者妊娠结局、凝血功能及不良反应的差异。结果观察组患者的活产率91.00%高于对照组的79.00%(P<0.05),治疗后的APTT、PT、CD4+、IFN-γ水平皆低于对照组(P<0.05),TT、FIB、PLT、CD8+水平皆高于对照组(P<0.05),出血、胃肠道反应、肝肾功能异常等不良反应的发生率6.00%低于对照组的18.00%(P<0.05)。结论低分子肝素钠联合阿司匹林对复发性流产的疗效确切,能够显著提高活产率,改善凝血功能与免疫功能水平,临床安全性高,值得推广应用。 展开更多
关键词 低分子肝素钠 阿司匹林 复发性流产 凝血功能 临床疗效
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