多器官功能不全综合征患者连续性血滤过程中肝素用量研究  

Dosage Analysis on Heparin for the Patients with MODS during Continuous Veno - venous Hemofiltration

作　　者：罗辉遇[1] 谢长江[2] 古英明[3] 陈飞鹏[4] 

机构地区：[1]广州医学院第二附属医院老年病学科,广东省广州市510260 [2]广州医学院第二附属医院ICU科,广东省广州市510260 [3]广州医学院第二附属医院血液净化中心,广东省广州市510260 [4]广州医学院第二附属医院呼吸内科,广东省广州市510260

出　　处：《中国全科医学》2010年第33期3759-3760,共2页Chinese General Practice

基　　金：广州市医药卫生科技项目(2007-YB-162)

摘　　要：目的研究MODS患者连续性静脉-静脉血液滤过(CVVH)过程中肝素的应用剂量变化,并探讨其临床意义。方法回顾性分析我院ICU 2003年6月—2008年6月38例MODS患者CVVH过程中肝素的应用剂量变化及其与病情的关系。结果 MODS患者CVVH治疗过程中普通肝素的平均用量为(2.9±1.5)mg/h,治疗开始6 h的平均用量〔(4.0±1.8)mg/h〕和最后6 h的平均用量〔(3.5±2.0)mg/h〕间差异无统计学意义(P>0.05);不同性别〔男:(3.0±1.6)mg/h;女:(2.8±1.4)mg/h〕、不同稀释法〔前稀释法:(2.8±1.7)mg/h;后稀释法:(3.0±1.4)mg/h〕患者肝素的平均用量间差异均无统计学意义(P>0.05);死亡患者肝素的平均用量〔(2.4±1.3)mg/h〕明显少于生存者〔(3.4±1.5)mg/h〕,差异有统计学意义(P<0.05);肝素平均用量<1.5 mg/h的患者均死亡。结论 MODS患者CVVH治疗过程中肝素的合理用量可能为(2.9±1.5)mg/h左右;肝素用量的大小可作为判断MODS患者预后的指标,当用量<1.5 mg/h时预后不良。Objective To investigate the changes of dosage and clinical significance of heparin during continuous veno-venous hemofiltration（CVVH） for the patients with multiple organ dysfunction syndrome（MODS）.Methods A retrospective analysis was made on 38 cases with MODS in the department of intensive care unit of our hospital from June 2003 to June 2008.The changes of dosage of heparin for the patients during CVVH were assessed.Results The mean dosage of heparin for the patients with MODS was（2.9 ± 1.5） mg/h,which was not significant different between the first and last 6h during CVVH（P 0.05）.No significant differences in dosage were found between the patients with different sex and under different dilution treatment（P 0.05）.The death group of the patients had significantly lower mean dosage of heparin compared with the survival group（P 0.05）.The death rate of the patients with less than 1.5 mg/h mean heparin dosage was 100%.Conclusion The suitable heparin dosage for the patients with MODS may be around（2.9 ± 1.5） mg/h.The level of heparin dosage can be a predictor of prognosis for the patients.When it is less than 1.5 mg/h,the prognosis is poor.

关 键 词：多器官功能衰竭 肝素 血液滤过 

分 类 号：R45[医药卫生—治疗学]