血栓弹力图对尿毒症血透患者凝血功能状态的监测效果  

Monitoring effect of thrombelastogram for the blood coagulation function in uremic hemodialysis patients

作　　者：张桂芬[1] 

机构地区：[1]保定市第一中心医院输血科,河北保定071000

出　　处：《中国卫生检验杂志》2016年第21期3175-3177,共3页Chinese Journal of Health Laboratory Technology

摘　　要：目的通过血栓弹力图对尿毒症透析患者凝血功能状态进行检测,指导透析患者使用肝素。方法选取2014年7月-2015年7月进行维持性透析的尿毒症患者50例,根据患者抗凝剂使用量分为低剂量组和高剂量组,其中低剂量组肝素总量<80 U/kg,高剂量组患者肝素使用量≥80 U/kg,检测患者透析前后以及透析2 h时患者凝血功能,并行血栓弹力图检测。结果透析2 h后,2组患者活化部分凝血活酶时间(APTT)、R值均大于透析前,差异有统计学意义(P<0.05)。低剂量组透析后APTT与透析前差异无统计学意义(P>0.05),但R值明显大于透析前,高剂量组透析后APTT、R值均大于低剂量组和透析前,差异有统计学意义(P<0.05)。透析后2组患者K值、MA值明显增加,CI值降低,高剂量组透析后K、MA高于低剂量组,CI值低于低剂量组,差异有统计学意义(P<0.05)。结论血栓弹力图有助于监测血透患者抗凝剂的使用。Objective The coagulation function of uremic hemodialysis patients was examined by thrombelastogram,so as to guide the use of heparin. Methods 50 patients maintening hemodialysis from July 2014 to July 2015 were selected,who were divided into low dose group and high dose group,with low dose heparin group total 80 U / kg and high dose heparin group ≥80 U / kg; blood coagulation function and thromboelastography were detected before and after dialysis or at 2 h after dialysis. Results The APTT,R of the two groups in 2 h after dialysis was significantly longer than that before dialysis,with the difference statistically significant（ P〈0. 05）. There was statistical significance on the difference of APTT in low dose group between after dialysis and before dialysis（ P〉0. 05）,but the R value was significantly greater than that of before,APTT,R value of high dose group were higher than that of low dose group and before dialysis,with the differences statistically significant（ P〈0. 05）.The K value and MA value significantly increased in the 2 groups after dialysis,the CI value decreased in the high dose group after dialysis,MA and K were higher,the CI value was lower than the low dose group,and the differences were statistically significant（ P〈0. 05）. Conclusion Thrombelastogram is helpful to the monitoring of anticoagulant in hemodialysis patients.

关 键 词：血栓弹力图 血液透析 肝素 凝血功能 

分 类 号：R459.5[医药卫生—治疗学]