2种低分子肝素给药方法在血液透析中抗凝效果的观察  

作　　者：潘晓东[1] 聂小兰[1] 程静刁[1] 杨栋[1] 

机构地区：[1]广东省深圳市中医院,广东深圳518033

出　　处：《当代护士（中旬刊）》2007年第9期19-20,共2页Modern Nurse

摘　　要：目的观察血液透析中低分子肝素的2种给药方法的抗凝效果。方法将31例有出血倾向的维持性血液透析患者随机分2组。A组每次透析均以肝素生理盐水预充循管并排净后接血路管,透析前10min从静脉端给药,低分子肝素钠首剂2500IU,此后每小时追加500IU;B组每次透析仅用生理盐水预充循管,透析开始时一次性从动脉端给低分子肝素5000IU。观察2组透析结束后穿刺点人工按压止血时间(MCT)、透析前后部分凝血活酶时间(APTT)、出血、透析器及管路回血时的凝血情况。结果2组均能顺利完成透析,透析器及管路回血时的均无明显凝血,A组抗凝效果优于B组(p<0.05),A组的压迫止血时间(MCT)较B组短(p<0.05),2组透析前后部分凝血活酶时间(APTT)无显著差异(p>0.05)。结论2种低分子肝素给药方法均能有效抗凝,减少出血倾向,A组抗凝效果优于B组,同时能减少低分子肝素用量,缩短穿刺点人工按压止血时间。Objective：To investigate the effect of two methods of low molecular heparin prescription in hemodialysis. Methods：31 maintenance hemodialysis patients with hemorrhagic tendency were randomized into two groups.Patients in group A were given hemodialysis after priming with heparin normal sodium,and were given 2500IU low molecular heparin （LMH）ten minutes before hemodialysis,then 500IU LMH was added every hour;patients in group B were given hemodialysis after priming with normal sodium,and were given 5000IU low molecular heparin.The time of pressing on the injection points when the dialysis was completed,APTT before and after each dialysis as well as extracorporeal circulation were observed. Results：Two groups finished the process successfully.There wasn＇t any blood coagulation in the dialysis machine.MCT of group A was significantly shorter than that of group B （p〈0.05）.There were no difference between APTT before and after hemodialysis of two groups （p〉0.05）. Conclusions： Two anticoagulation methods provide an effective and safe effect in hemodialysis patients.The dose of low molecular heparin and the time of pressing on the injection points were less in group A than that of group B.

关 键 词：低分子肝素 血液透析 抗凝 出血倾向 

分 类 号：R473.5[医药卫生—护理学]