不同浓度肝素封管液对老年病人静脉留置针置管时间及出凝血机制的影响分析  

作　　者：林楚玉[1] 许静华[1] 孙淑銮[1] 林丽容[1] 

机构地区：[1]揭阳市人民医院外三科,广东揭阳522000

出　　处：《现代临床护理》2010年第5期12-14,共3页Modern Clinical Nursing

摘　　要：目的探讨不同浓度肝素封管液对老年病人静脉留置针置管时间及出凝血机制的影响,为临床老年病人使用最佳浓度的肝素封管液提供理论依据。方法将160例使用浅静脉留置针的老年病人随机分为A、B、C、D4组,A组为对照组,B、C、D组为实验组,每组各40例。A、B、C、D组各采用2mL用0.9%生理盐水稀释的不同浓度肝素封管液进行正压封管:浓度分别为含肝素62.50u/mL、78.0u/mL、100.0u/mL、125.0u/mL。比较4组病人静脉留置针的置管时间及封管前后凝血酶原时间(prothrombin time,PT)、活化部分凝血活酶时间(activated partial thromboplastin time,APTT)、纤维蛋白原(fibrinogen,Fg)。结果 4种不同浓度肝素封管液对留置针置管时间不同(均P<0.05);A组与B、C组,B组与C组比较,均P>0.05,差异无统计学意义;D组与A、B、C组比较,均P<0.05,差异具有统计学意义,D组肝素封管液封管效果最佳。4种不同浓度肝素封管液封管前以及拔针后24hPT、APTT、Fg比较,均P>0.05,差异无统计学意义。结论出凝血机制正常的老年病人使用上述不同浓度的肝素封管液是安全可靠的,应用含肝素125u/mL的肝素封管液2mL对老年病人进行正压封管能使留置针达到最佳的留置时间。Objective To discuss the influence of heparin solution with different concentration on the detaining time of venous indwelling needle and the hemorrhage and coagulation mechanism for the senile patients, and provide basis on using heparin solution for the clinical. Methods One hundred and sixty senile patients using intravenous catheter system with PRN were randomly divided into A, B, C and D four groups. Guorp A was control group, group B, C and D were experimental groups. There were forty patients in each group. The tubes were sealed up under positive pressure with different concentrations of heparin solution which diluted in 2 mL physiological saline all groups： the heparin concentration of A was 62.50 u/mL, B was 78.0 u/mL, C was 100.0 u/mL, and D was 125.0 u/mL. The detaining time of venous indwelling needle, prothrombin time （PT） before and after sealing, activated partial thromboplastin time （APTT） and fibrinogen （Fg） of four groups were compared. Results Significant difference was found in detaining days between Group D and the other three groups （P 〈 0.05） ; when the heparin concentration was 125.0 u/mL, the sealing effect was best; before sealing up the tube and removing the needle twenty-four hours later, no statistical difference was found in IT, APTr and Fg between the four groups （P 〉 0.05）. Conclusion It is safe and trustworthy to use different concentrations of heparin solution for the senile patients whose hemorrhage and coagulation are normal, and the optimal detaining time of venous indwelling needle can he obtained by using positive pressure sealing and using 2 mL heparin solution whose concentration is 125 u/mL.

关 键 词：静脉留置针 肝素封管液 老年患者 置管时间 出凝血机制 

分 类 号：R472[医药卫生—护理学]