中心静脉导管动静脉端交换使用对透析充分性及透析抗凝的影响  

The Influence of the Sufficiency and Anticoagulant on Interchange able Use of the Arterial and Veinal end of Central Venous Catheter in Hemodialysis

作　　者：齐辉[1] 彭俊眉[1] 冯英[1] 

机构地区：[1]成都市第三人民医院,四川成都610031

出　　处：《现代临床医学》2011年第2期140-141,共2页Journal of Modern Clinical Medicine

摘　　要：目的:了解中心静脉导管动静脉端交换使用对透析充分性及透析抗凝的影响。方法:选取进行血液透析并采用临时性中心静脉导管作为血管通路的患者40例,采用自身前后对照,交叉使用中心静脉导管动静脉端进行血液透析。采集患者血液测定透析前后肌酐和尿素氮,并记录患者透析能达到的最大的血流量、体重、脱水量和透析完成后患者透析管路的凝血状况。计算出尿素清除指数(Kt/V)及统计患者凝血情况(即统计出现凝血或凝血状况恶化的患者数目)。结果:中心静脉导管动静脉端交换前Kt/V为1.22±0.18,交换后患者的Kt/V下降0.97±0.12,下降约20%,与交换前相比有显著性差异(P<0.05);透析管路微凝血块的发生率较前增加,有显著性差异(P<0.05)。结论:中心静脉导管动静脉端交换使用导致患者透析充分性下降,并使患者管路凝血状况恶化,从而需要增加抗凝剂量。Objective：To evaluat the influence of the sufficiency and anticoagulant on interchangeable use of the arterial and veinal end of central venous catheter（CVC） in hemodialysis. Methods：Interchangeable use of the arterial and veinal end of central venous catheter in hemodialysis was performed in 40 cases lately.By Self-control before and after methods,tested and analysed the serum creatinine and Blood urea nitrogen before and after dialysis.Recorded maximum blood flow,body weight,the amount of dehydration during dialysis and the micro blood clot in the pipeline of hemodialysis after dialysis.Understood the coagulation status of patients and calculated Kt/V. Results：Before cross-artery-vein-side use of CVC,Kt/V was 1.22±0.18;after the exchange use,Kt/V was 0.97±0.12,it reduced by 20%（P〈0.05）.The incidence of micro blood clot in the pipeline of hemodialysis significantly increased after the exchange use（P〈0.05） too. Conclusion：Cross-artery-vein-side use of CVC results in inadequacy dialysis in patients,and increases the incidence of micro blood clot in the pipeline of hemodialysis.So the amount of anticoagulant needs increasing.

关 键 词：中心静脉导管 KT/V 凝血状况 

分 类 号：R473.5[医药卫生—护理学]