流行性出血热急性肾衰血透中肝素的使用  

Heparin usage during hemodialysis for acute renal failure by epidemic hemorrhagic fever

作　　者：杨亦彬[1] 刘永[1] 曾华清[1] 曹代君[1] 陈忠霞[1] 祝荣文[1] 

机构地区：[1]遵义医学院第一附属医院内科

出　　处：《遵义医学院学报》1999年第1期36-38,共3页Journal of Zunyi Medical University

摘　　要：目的探讨流行性出血热急性肾功能衰竭血液透析中肝素的使用。方法在凝血时间监测下，对65例病例根据出血情况予常规全身肝素化、小剂量肝素化抗凝及无肝素透析，观察出血、凝血情况及透析效果。结果肝素抗凝透析，出血加重率5．9％～8．2％，均不严重，继续透析后减轻，透析器凝血率1．6％～5％。无肝素透析组无1例加重出血，但凝血率28．1％。3组血流量相同时Cr清除率比较无明显差异。结论流行性出血热急性肾功能衰竭血液透析中肝素的使用宜根据病情决定，若无严重性出血，适量肝素抗凝是有益的，但若有严重活动性出血，首选无肝素透析，保证高血流量是防止凝血关键。To inquire into the usage of heparin during hemedialysis for acute renal failure(ARF) by epidemic hemorrhagic fever (EHF). Methods According to the extent of hemorrhage, 65cases of ARF by EHF were hemedialized with weher ①routine heparinization intravenously, or② lowdose of heparinizatino or ③ hepdrin-free, while coagulation time monitored, and hernorrhagiccomplication, ccagulation and dialysis effect observed. Results In heparinized groups, the rates ofwosened hemorrhage were 5. 9 % ~ 8. 2 % (The worsened hemorrhage was not very serious in all casea butalleviated after further dialysis) and the rates of dialyzer coagulation 1. 6% ~5%. In heparin-free group,no worsened hemorrhage occured, but the coagulation rate was 28.1%. There was no significantdifference on clearance rate of Cr between these groups when their blood flows were same. ConclusionsThe result suggests that, during hemedialysis for ARF by EHF, the usage of heparin depends uponpatient s condition: when no serious active bleeding, adequate heparin is benefit, but When serious activebleedig exists, heparin-free henndialysis is necmp, and that hige blood flow is main guarantee againstcoagulation.

关 键 词：流行性出血热 急性肾功能衰竭 出血 血液透析 肝素 

分 类 号：R512.8[医药卫生—内科学]