低分子肝素干预治疗下ICU患者动静脉冲管液的选择与研究  

Selection and care of arteriovenous rinse solution for ICU patients treated by low molecular weight heparin intervention

作　　者：丁洁芳[1] 杨晓歆[1] 严佳[1] 

机构地区：[1]江苏省南京市胸科医院,江苏南京210029

出　　处：《护士进修杂志》2014年第16期1453-1455,共3页Journal of Nurses Training

基　　金：江苏省南京市卫生局科技发展项目(编号:YKK12151)

摘　　要：目的探讨行低分子肝素抗凝干预治疗的危重症患者,用生理盐水代替普通肝素盐水作为有创动脉及中心静脉测压管冲管液的可行性和临床意义。方法将77例行持续动静脉压监测并同步抗凝干预治疗的患者随机分为对照组(肝素组)38例和观察组(生理盐水组)39例,分别用肝素化生理盐水(2.5U/ml)或生理盐水作为动静脉测压管冲管液。记录两组患者的动静脉置管时间,评估导管通畅性和患者皮下出血情况,监测血小板计数。结果两组平均动静脉置管时间和堵管率差异无显著意义(P>0.05);对照组皮下出血和严重血小板减少的发生率均高于观察组(P<0.05)。结论用生理盐水作为ICU同步抗凝治疗患者动静脉测压管的冲管液,既能保证管道的通畅,同时又降低了患者血小板抑制和出血的风险,值得临床推广应用。Objective To study the feasibility and clinical significance of normal saline instead of unfractionated heparin with saline as invasive arterial and central venous pressure measurement tube washing fluid for critically ill patients treated by low molecular weight heparin therapy. Method 77 patients with continued arterial and central venous pressure monitoring were selected and randomly divided into heparin group（38 cases） and normal saline group （39 cases）. Heparinized saline （2.5 U/ml） or saline as arteriovenous piezometric tube washing fluid respectively. Patients＇ arteriovenous catheterization time, assess catheter pateney and subcutaneous bleeding in the two groups was recorded and evaluated. The platelet count was monitored. Result The mean arterial and venous catheterization time and plugging was no significant difference （P〉0.05）. Heparin subcutaneous hemorrhage and severe thrombocytopenia were higher than that of normal saline group （P〈0.05）. Conclusion Normal saline as arteriovenous piezometric tubes washing liquid for patients with ICU sync anticoagulant therapy was both to ensure smooth pipes and reduce the risk of platetet inhibition and bleeding.

关 键 词：低分子肝素 普通肝素 生理盐水 中心静脉 有创血压监测 冲管液 

分 类 号：R472[医药卫生—护理学]