微量肝素抗凝法在尿毒症高危出血倾向患者血液透析中的应用效果  

The hemodialysis application effect of microscale heparin anticoagulation in uremia patients with high risk of bleeding tendency

作　　者：梅蓓 王莎莎 郭志萍 张登峰 张文丰 古英明 MEI Bei;WANG Sha-sha;GUO Zhi-ping;ZHANG Deng-feng;ZHANG Wen-feng;GU Ying-ming

机构地区：[1]东莞康华医院血液透析中心,东莞市523000

出　　处：《护理实践与研究》2018年第6期32-34,共3页Nursing Practice and Research

基　　金：2015年东莞市医疗卫生科技计划一般项目(2015105101030)

摘　　要：目的:探讨透析微量肝素法在尿毒症高危出血倾向患者血液透析中的应用效果。方法:选取2015年2月至2017年7月我科接收的行血液透析治疗且伴有高危出血倾向的尿毒症患者116例,并随机等分为观察组与对照组,对照组行无肝素透析法抗凝,观察组采取微量肝素法抗凝。对两组患者出血情况、体外循环凝血状况、血透充分性、每次透析维持时间及凝血指标变化情况进行比较。结果:观察组出血率与对照组比较差异无统计学意义(P>0.05);观察组体外循环凝血发生率较对照组低(P<0.05);观察组整体尿素清除率(KT/V)较对照组高(P<0.05),每次透析维持时间较对照组长(P<0.05);观察组透析后凝血酶时间(TT)测量值较对照组高(P<0.05)。结论:在尿毒症高危出血倾向患者血液透析中采用微量肝素法,既可提高血液透析的效果,又不会使出血危险增加。Objective:To explore the hemodialysis application effect of dialysis microscale heparin in uremia patients with high risk of bleeding tendency.Methods:To select 116 uremia patients who received hemodialysis treatment and had high risk of bleeding tendency from February 2015 to July 2017 in our department,randomly and equally divided them into observation group and control group.The control group was given anticoagulation without heparin dialysis,while the observation group was given anticoagulation with a microscale heparin method.The hemorrhage,coagulation of extracorporeal circulation,adequacy of hemodialysis,duration of each dialysis,and changes in clotting parameters were compared between the two groups.Results:Difference was no statistic significance in the bleeding rate between the observation group and the control group(P>0.05);in terms of the incidence of coagulation,the observation group was lower than the control group(P<0.05);as for the overall urea clearance rate(KT/V),the observation group was higher than the control group(P<0.05),with regard to the duration of each dialysis,observation group was longer than control group(P<0.05).Thrombin time(TT)measured after the dialysis of observation group was higher than that of the control group(P<0.05).Conclusion:The hemodialysis application of the microscale heparin method in uremia patients with high risk bleeding tendency can improve the effect of hemodialysis,as well as reduce the risk of hemorrhage.

关 键 词：透析微量肝素法 尿毒症 高危出血倾向 血液透析 

分 类 号：R473.5[医药卫生—护理学]