密闭式回血法在无肝素血液透析中的应用  

Application of airtight blood re-infusion method to heparin-free hemodialysis

作　　者：邓东亲[1] 葛文娥[1] 蒋瑞芬[1] 魏晓霞[1] 李晓凤[1] 

机构地区：[1]苏州大学附属第四医院血液净化中心,无锡214062

出　　处：《中国血液净化》2011年第4期221-223,共3页Chinese Journal of Blood Purification

摘　　要：目的探讨无肝素血液透析结束时,对患者采用密闭式回血法是否适合。方法选择接受血液透析的患者71例,共治疗100例次,包括无肝素血液透析治疗50例次(试验组);其余50例次做为(对照组)。观察透析器凝血情况,对条件适合的患者采用密闭式回血法。对比密闭式回血法在肝素组与无肝素组患者的应用情况,分析密闭式回血过程中透析管路及透析器凝血情况的组间差异。对比接受无肝素透析与有肝素透析患者在密闭式回血的时间,加压次数的差异。结果无肝素透析患者密闭式回血法的完成率明显少于对照组(P<0.05);无肝素组密闭式回血透析管路及透析器凝血发生率较有肝素透析明显增高(P<0.05);密闭式回血的时间、加压次数在两组间差异不明显(P>0.05)。结论无肝素血液透析患者,当透析器凝血呈0级或1级时,可以考虑应用密闭式回血法,回血过程中仍应注意观察凝血的发生。Objective To study whether airtight blood re-infusion method was suitable for the heparin-free hemodialysis.Method Seventy-one patients with hemodialyis（100 dialysis sessions） were enrolled in this study,including 21 patients treated with 50 sessions of heparin-free hemodialysis（experimental group） and 50 maintenance hemodialyis patients with heparin in hemodialysis（control group）.Airtight blood re-infusion method was used when the patients met the criteria.The extent of clots in pipeline and dialyzer after airtight blood re-infusion,the operation time for the re-infusion,and the frequency of pressure applied to the re-infusion were observed and compared between the two groups.Result The completion rate of airtight blood re-infusion was significantly lower in experimental group than in control group（P〈0.05）.The occurrence of clots in pipeline or dialyzer in airtight blood re-infusion was significantly higher in experimental group than in control group（P〈0.05）.However,the operation time for airtight blood re-infusion,and the frequency of pressure applied to the blood re-infusion were insignificant between the 2 groups（P〉0.05）.Conclusion Airtight blood re-infusion method can be considered for patients using heparin-free hemodialysis when the presence of clots in pipeline ranks 0 or 1.During the airtight blood re-infusion,blood clotting in pipeline should be always monitored.

关 键 词：肝素 血液透析 密闭式回血 

分 类 号：R472.9[医药卫生—护理学] R459.5[医药卫生—临床医学]