无肝素血液透析在肾炎合并高度出血危险透析患者中的应用研究  

Application of Heparin-free Hemodialysis in the Nephritis Complicated with High Hemorrhage in Nephritis

作　　者：王凤君[1] 张桂月[1] 吕莹[1] 关美玉[1] 朱向阳[1] 

机构地区：[1]中国医科大学附属第一医院鞍山医院肾内科,鞍山114000

出　　处：《中国医药导刊》2015年第2期146-147,150,共3页Chinese Journal of Medicinal Guide

摘　　要：目的:探讨无肝素血液透析在肾炎合并高度出血危险透析患者中的疗效及安全性。方法:对照组患者采取常规血液透析治疗;治疗组采取无肝素血液透析治疗,比较两组患者透析的例次及患者的预后情况,比较两组患者的体外循环凝血情况,比较患者治疗后的BUN、血钙、血钾、血浆PH及碳酸氢根离子。结果:对照组患者共透析182例次,治疗结束后57例(90.48%)存活,其中,47例(74.60%)患者肾功能恢复良好;观察组患者共透析190例次,治疗结束后61例(96.83%)患者存活,其中56例(88.89%)患者肾功能恢复良好,两组患者透析例次和存活患者例数无统计学差异(P>0.05),肾功能恢复的患者例数具有统计学差异(P<0.05)。两组患者均出现不同程度的凝血,对照组凝血发生率9.52%,观察组15.87%,二者之间不具备统计学差异(P>0.05)。两组生存的患者透析后的血生化检查和血气分析结果无统计学差异(P>0.05),患者透析治疗结果相当。结论:无肝素透析可降低肾炎合并高度出血危险透析患者出血的发生风险,改善预后,该治疗较为安全,适合在临床上应用。Objective： To explore the clinical efficacy and safety of non-heparin hemodialysis in nephritis complicated with high hemorrhage.Methods：While patients in the control group took routine hemodialysis treatment,the treatment group was given heparin-free hemodialysis treatment.Dialysis and the prognosis of the two groups of patients were compared,and coagulation during cardiopulmonary bypass and BUN,serum calcium,potassium,plasma p H and bicarbonate in patients after treatment were also compared.Results：In the control group,there were 182 cases of patients with dialysis,among which 57 cases（90.48%） survived after the treatment,including 47 cases（74.60%） renal function in patients with good recovery;190 cases of patients in observation group were going through dialysis,61 cases（96.83%） of patients survived after the treatment,including 56 cases（88.89%） renal function in patients with good recovery.The comparison of two groups of patients with dialysis showed no significant difference in the survival time and the number of patients（P〈0.05）,the number of patients with renal function recovery with statistical difference（P〉0.05）.Two groups of patients were with varying degrees of coagulation,while the incidence of coagulation in the control group was 9.52%,but that of the observation group was 15.87%,no statistical significant difference between the two groups（P〉0.05）.The blood biochemical examination and blood gas analysis results of two groups of patients after the survival of dialysis showed no significant difference（P〉0.05）,with similar effect on the patients with dialysis treatment.Conclusion：Heparin-free hemodialysis can reduce nephritis the risk of bleeding occurred in dialysis patients and improve the prognosis;the treatment is safe,therefore suitable for clinical application.

关 键 词：无肝素血液透析 肾炎 高度出血危险 临床疗效 安全性 

分 类 号：R692.3[医药卫生—泌尿科学]