低分子肝素抗凝在血液灌流治疗中的应用  

Utilization of Low Molecular Weight Heparin(LMWH) Anticoagulation in Treatment of Hemoperfusion

作　　者：黄旭东[1] 张丽霞[1] 王丽辉[1] 吴广礼[1] 

机构地区：[1]解放军白求恩国际和平医院肾脏病科北京军区肾脏病研究诊疗中心,石家庄050082

出　　处：《临床误诊误治》2013年第1期69-71,共3页Clinical Misdiagnosis & Mistherapy

基　　金：全军十二五基金重点资助项目(BWS11J058)

摘　　要：目的观察低分子肝素作为抗凝剂在血液灌流治疗中的有效性及安全性。方法选择我院2011年1月—12月行血液灌流治疗的180例,按性别、病种分层随机分为应用低分子肝素治疗的低分子肝素组及应用普通肝素治疗的普通肝素组,每组各90例。观察并比较两组的管路凝血、出血情况及血小板计数、部分凝血活酶时间(APTT)。结果低分子肝素组均未发生灌流器凝血,穿刺点无明显出血;普通肝素组有7例(7.8%)出现凝血,11例(12.2%)发生出血,其中8例渗血,3例流血。两组管路凝血及穿刺点出血发生率比较,差异均有统计学意义(P<0.05)。与治疗前比较,血液灌流治疗后低分子肝素组血小板、APTT均无明显变化(P>0.05),普通肝素组血小板减少(P<0.05),APTT明显延长(P<0.05)。结论低分子肝素作为抗凝剂较普通肝素具有更好的抗凝效果,且能有效降低出血发生率,可在血液灌流治疗中常规使用。Objective To assess the efficacy and safety of low molecular weight heparin （LMWH） anticoagulation in treatment of hemoperfusion. Methods One hundred and eighty patients treated by hemoperfusion during January 2011 and December 2011 in our hospital were randomly divided into LMWH group （u = 90） and common heparin group （n = 90） by gender and entity demixing. The blood coagulation, bleeding, BPC and partial thromboplastin time （APTT） of the two groups were observed and compared. Results There was no blood coagulation in the perfusions and pipelines of LMWH group and obvious bleeding, in paracentesis points ; there were 7 cases （7.8%） of blood clotting and 11 cases （12.2%） of bleeding including 8 cases of errhysis and 3 cases of bleeding in common heparin group. The differences of incidence rates in blood coagulation in the perfusions, pipelines and paracentesis points of the two groups were of statistical significance （P 〈0. 05）. There was no obvious changes in blood platelets and APTT in LMWH group after hemoperfusion therapy and before treatment （P 〉 0. 05）, while in common heparin group, blood platelets were obviously reduced （P 〈 0. 05）, and APTT was obviously lengthened （P 〈 0. 05）. Conclusion As an anticoagulant agent, the LMWH has a better anticoagulation effect which may effectively reduce incidence rate of bleeding and can be used routinely in hemoperfusion therapy.

关 键 词：低分子量肝素 肝素 血液灌注 抗凝 

分 类 号：R459.5[医药卫生—治疗学]