无肝素血液透析中凝血的原因分析和护理对策  

Analysis and nursing countermeasures on blood clotting in no-heparin hemodialysis

作　　者：徐美[1] 

机构地区：[1]江苏省启东市人民医院血液净化中心,226200

出　　处：《山西医药杂志》2015年第2期144-146,共3页Shanxi Medical Journal

摘　　要：目的探讨无肝素血液透析发生凝血的原因和护理对策。方法用0.9%氯化钠注射液预冲透析器和血路管,并在透析时定时用0.9%氯化钠注射液冲洗管路和透析器,血流量250~300mL/min。结果 35例患者共透析175次,有3次患者发生Ⅲ级凝血提前结束透析,2次发生Ⅲ级凝血更换透析器。结论医护人员有高度的责任心,保证有效的血流量,控制超滤量,定时0.9%氯化钠注射液冲洗透析器及管路,避免空气进入循环管路,避免在透析装置系统输注血制品等护理措施是无肝素透析顺利进行的保障。Objective To explore the causes of coagulation in heparin free hemodialysis and nursing stragi‐ties .Methods We pre‐flushed dialyzer and blood clotting of pipelines by physiological saline .During hemodialysis , the pipeline of dialyzer was flushed by physiological saline ,Blood flow was 250 ~ 300 mL/min. Results A total of 35 patients were on dialysis for 175 times .There are three patients got early termination of dialysis because of de‐veloping grade Ⅲ clotting ,2 times of replacement for dialyzer because of grade clotting .Conclusion Health care workers have a high degree of responsibility .Those nursing measures ,such as ensuring the effective blood flow , controlling ultrafiltration ,timing saline flush dialyzers and piping ,avoiding air into the circulation line and avoiding transfusion of blood products can guarantee that non‐heparin dialysis is carried out smoothly.

关 键 词：血液透析滤过 血液凝血 护理 

分 类 号：R473.5[医药卫生—护理学]