微量肝素持续滴入法在血液透析高危出血患者中的临床观察  

Clinical Observation of Continuous Hereditary dose of Heparin in Hemodialysis Patients with high risk Bleeding

作　　者：林璟华[1] 王潘[1] 曾志力[1] 古英明[1] 

机构地区：[1]广州医科大学附属第二医院,广州510260

出　　处：《血栓与止血学》2018年第1期21-22,25,共3页Chinese Journal of Thrombosis and Hemostasis

摘　　要：目的观察有高危出血倾向的尿毒症患者应用微量肝素持续滴入法在血液透析中的抗凝效果。方法将40例有高危至极高危出血倾向的尿毒症患者,随机分成对照组和观察组各20例,分别应用无肝素法和微量肝素持续滴入法进行血液透析,观察两组患者透析后体外循环凝血情况,并对观察组透析前、后的活化部分凝血活酶时间(a PTT)、凝血酶时间(TT)、抗凝血酶(AT)、血小板计数(BPC)进行比较。结果对照组体外循环凝血发生率高于微量肝素持续滴入法,差异具有统计学意义(P﹤0.05);观察组透析前、后的a PTT、TT、AT、BPC这四个指标差异均无统计学意义(P>0.05),没有加重患者出血症征。结论微量肝素持续滴入法对有高危出血的血液透析患者未增加出血的倾向,且体外循环堵塞少,方法简便易行、疗效确切。Objective To observe the anticoagulant effect of sustained intravenous infusion of heparin in hemodialysis in uremic patients with high risk bleeding tendency. Methods 40 cases of uremic patients with high risk and high risk bleeding were randomly divided into control group （ 20 cases） and observation group （20 cases）, hemodialysis without heparin method and trace heparin continuous drip method. The two groups patients activated partial thromboplastin time （ aPTT）, thrombin time （ TT）, antithrombin （AT） and blood platelet count （BPC）were measured before and after dialysis. Results The incidence of coagulation in the control group was higher than that in the control group （ P 〈 0. 05 ）. The four indexes difference was not statistically significant （ P 〉 0. 05 ）, did not increase the signs of bleeding in observation group pafients. Conclusion The sustained dose of heparin can not increase the tendency of bleeding in hemodialysis patients with high risk bleeding, and the extracorporeal circulation is less and the method is simple and effective.

关 键 词：血液透析 微量肝素 高危出血 

分 类 号：R459.5[医药卫生—治疗学]