改良式预冲在透析并发脑出血患者行无肝素连续性肾脏替代治疗中的临床应用  

The clinical application of modified preflush in the treatment of CRRT without heparin for patients received dialysis with complication of cerebral hemorrhage

作　　者：王媛媛[1] 朱莹[1] 

机构地区：[1]中国医科大学附属第一医院血液净化室,辽宁沈阳110001

出　　处：《中国医学装备》2017年第7期107-109,共3页China Medical Equipment

摘　　要：目的:探讨改良式预冲方法在透析并发脑出血患者行无肝素连续性肾脏替代治疗(CRRT)中的临床应用效果。方法:选取在医院行无肝素CRRT的44例透析并发脑出血患者,将其以开展改良式预冲方法的时间为临界点分为传统组(28例)和改良组(16例),回顾性分析比较传统式预冲和改良式预冲方法在滤器凝血等级指标及滤器使用寿命方面的效果。结果:两种预冲方法的滤器Ⅰ、Ⅱ、Ⅲ级凝血指标差异有显著统计学意义(x^2=12.020,P<0.05);滤器平均使用时间、跨膜压(TMP)、滤器压、压力下降(ΔP)值的比较差异有显著统计学意义(t=3.535,t=4.024,t=6.071,t=3.524;P<0.01),两种方法的静脉压(PV)值差异也有统计学意义(t=2.166,P<0.05),而血流量(BFR)、超滤率(UFR)、动脉压(Pa)值差异无统计学意义(P>0.05)。结论:改良式预冲能使滤器纤维更加充分的舒展和浸透,可延长滤器使用时间,降低凝血发生率,保证治疗效果及过程顺利。Objective： To explore the clinical effect of modified preflush on the treatment of CRRT without heparin in patients received dialysis with complication of cerebral hemorrhage. Methods： 44 patients received dialysis with complication of cerebral hemorrhage were divided into control group（28 cases） and observation group（16 cases） according to the implemented time of modified preflush. A retrospective analysis was adopted to compare the effect of filter in blood coagulation grade and service life between conventional preflush（control group）and modified preflush（observation group）. Results： The differences of I, II, III grade of blood coagulation between the two methods were significant（χ^2=12.020, P〈0.05）, and the differences of average service time of filter, transmembrane pressure（TMP）, pressure of filter and value of pressure drawdown（ΔP） between the two methods also were significant（t=3.535, t=4.024, t=6.071, t=3.524, P〈0.01）. Besides, the difference of venous pressure（PV） between them was significant（t=2.166, P〈0.05）, while the differences of BFR, UFR and Pa between the two methods were not significant（t=0.263, t=1.162, t=0.258, P〉0.05）. Conclusion： Modified preflush method can make the fiber of filter to obtain more full stretch and soak, and it also can prolong the service of time, and decrease incidence of blood coagulation, and ensure curative effect and smooth process.

关 键 词：改良式预冲 透析 脑出血 无肝素 连续性肾脏替代治疗 

分 类 号：R459.5[医药卫生—治疗学]