无肝素抗凝治疗在重症胰腺炎患者血液净化过程中的临床效果  

Clinical effects of heparin free anticoagulation therapy in blood purification in patients with severe acute pancreatitis

作　　者：李汝芬[1] 徐立萍[1] 赵文文[1] 

机构地区：[1]滨州医学院附属医院血液透析室,山东省滨州市256603

出　　处：《世界华人消化杂志》2015年第3期466-469,共4页World Chinese Journal of Digestology

摘　　要：目的:探讨临床中无肝素抗凝在重症胰腺炎患者(severe acute pancreatitis,SAP)血液净化中的应用效果.方法:将选取的78例SAP依据随机盲法对照试验分为研究组和对照组,对照组给予常规低分子肝素抗凝治疗,研究组给予无肝素抗凝治疗,观察两组临床效果.结果:治疗8 h和治疗结束时活化部分凝血活酶时间(activated partial thromboplastin time,APTT)和凝血酶原时间(prothrombin time,PT)较治疗前有明显的变化,且组间的数据比较差异有统计学意义(P<0.05);研究组滤器寿命、血尿素氮(blood urea nitrogen,BUN)下降率、血清肌酐(creatinine,Cr)下降率vs对照组差异无统计学意义(P>0.05);研究组出血发生率为5.1%v s对照组的17.9%,差异有统计学意义(P<0.05).结论:临床中对于SAP患者血液净化治疗中应用无肝素抗凝治疗是可行的,尤其在降低出血方面具有重要的作用.AIM： To investigate the clinical effects of heparin free anticoagulation therapy in blood purification in patients with severe acute pancreatitis（SAP）.METHODS： Seventy-eight SAP patients were randomized into either a study group or a control group. The control group received conventional low molecular weight heparin therapy, and the study group received heparin free anticoagulation therapy. Clinical effects were observed and compared for the two groups.RESULTS： Activated partial thermoplastic time（APTT） and thrombotic time（PT） at 8 h after treatment and at the end of treatment showedsignificant changes compared with those before treatment in both groups, and the differences between the two group were also statistically significant（P〈0.05）. The filter life, blood urea nitrogen（BUN） decline rate, and serum creatinine（Cr） decline rate were not significantly different from those in the control group（P〈0.05）. The rate of bleeding was significantly lower in the study group than in the control group（5.1% vs 17.9%, P〈0.05）.CONCLUSION： The application of heparin free anticoagulation therapy in blood purification in SAP patients is feasible and can reduce rate of bleeding.

关 键 词：血液净化 无肝素抗凝 重症胰腺炎患者 临床疗效 

分 类 号：R576[医药卫生—消化系统]