短暂关闭静脉测压管夹在无肝素透析冲洗管路中的应用价值  

Application value of temporary closure of venous pressure clamp in duct rinsing during heparin free dialysis

作　　者：陈春霞[1] 翁卫群[1] 陈冬梅[1] Chen Chunxia Weng Weiqun Chen Dongmei(Blood Purification Center, Nantong First People Is Hospital, Nantong 226001, China)

机构地区：[1]江苏省南通市第一人民医院血透室,226001

出　　处：《中国综合临床》2017年第8期701-704,共4页Clinical Medicine of China

摘　　要：目的 探讨无肝素透析冲洗时短暂关闭静脉测压管夹对滤器凝血的影响.方法 将140例次无肝素血液透析患者按单数次透析治疗和双数次透析治疗分为对照组（单数次无肝素透析74例次）和观察组（双数次无肝素透析66例次）.对照组冲洗操作与普通透析治疗结束下机回血的流程一致.观察组在冲洗开始前关闭静脉测压管夹,冲洗完全结束后再打开静脉测压管夹,其余操作同对照组.比较两组患者血透机报警次数和血泵暂停的时间,凝血的发生率及凝血的程度,观察两组患者冲洗过程中的舒适度.结果 两组患者血透机报警次数和血泵暂停时间比较,差异有统计学意义（P=0.001）;凝血发生率及凝血程度、提前下机情况对照组8.1%（6/74）、观察组0）,两组滤器凝血程度比较差异有统计学意义（Z=-9.185,P=0.000）.患者的舒适度评分对照组为（4.80±1.00）分、观察组为（4.20±0.63）分,差异有统计学意义（P=0.001）.结论 无肝素血液透析冲洗管路时,短暂关闭静脉测压管夹能使透析治疗中断减少,延长滤器使用寿命,保证患者的透析时间和治疗效果,患者舒适度提高.Objective To study the effect of temporary closure of venous pressure clamp on blood coagulation during duct rinsing in heparin free dialysis.Methods One hundred and forty cases of heparin free dialysis were divided into the control group and observation group according to the singular times dialysis and dual time dialysis,the control group （74 cases with singular times heparin free dialysis） and observation group （66 cases with dual times heparin free dialysis）.The rinsing operation of the control group was consistent with the routine dialysis process.In the observation group,the venous pressure clamp was closed before the start of rinsing,and then the venous pressure clamp was opened at the end of this process.The times of alarm,blood pump suspension period,incidence rate and degree of blood coagulation were compared between the two groups to assess the degree of comfort and compliance of all patients during the process.Results The differences between the two groups in terms of times of alarm and blood pump suspension period were statistically significant （（5.7±1.8） times vs.0 times,（9.1±4.0） s vs.0s,P=0.001）,the incidence rate of blood coagulation,the degree of blood coagulation above degree Ⅱ and the rate of operation completion ahead of time in the two groups were detected （（70.3% （52/74） vs.7.6% （5/66）,21.6% （16/74） vs.0,8.1% （6/74） vs.0）.The difference of blood coagulation degree between the two groups was statistically significant （Z=-9.185,P=0.000）.Patients in the observation group had a higher grade of comfort degree（（4.8±1.0） points vs.（4.2±0.63） points,P=0.001）.Conclusion In the operation of heparin free dialysis,the temporary closure of venous pressure clamp can reduce the incidence rate of interruption,prolong the service life of the filter,ensures the dialysis time and treatment effect,and improve the patients＆#39; degree of comfort.

关 键 词：静脉测压管夹 无肝素透析 冲洗 凝血 舒适度 

分 类 号：R692.5[医药卫生—泌尿科学]