MHD患者应用枸橼酸钠和肝素钠对Cuff导管维持开放的效果  

Therapeutic effects and safety of sodium citrate and heparin in maintaining the opening of Cuff catheters in hemodialysis patients

作　　者：梁晓倩 杨爽 张放 孙怡芸 周西豫[5] LIANG Xiaoqian;YANG Shuang;ZHANG Fang(Department of General Practice,Health Team of Weinan Branch of Shaanxi Armed Police Corps,Shaanxi,Xi’an 710000,China)

机构地区：[1]武警陕西总队渭南支队勤务保障大队卫生队全科,西安市710000 [2]武警重庆总队执勤第一支队勤务保障大队卫生队全科 [3]武警第一机动总队机动第一支队勤务保障大队卫生队全科 [4]武警总医院病理科 [5]武警陕西总队医院血透中心

出　　处：《河北医药》2019年第21期3253-3256,共4页Hebei Medical Journal

摘　　要：目的探讨枸橼酸钠和肝素钠应用于血液透析(MHD)患者封存Cuff导管的安全性和有效性。方法收治的MHD患者118例随机分为枸橼酸钠组和肝素钠组,每组59例,比较2组患者治疗前、后凝血功能、血清生化指标含量的差异,比较2组患者透析过程中导管-透析时间、CRIs发生次数、导管内抽吸血栓次数、导管功能不良次数的差异,比较2组患者滤器凝血分级的差异。结果 2组患者治疗后比较,PT、APTT、 PLT、Cre、BUN差异有统计学意义(P<0.05),肝素钠组患者PT、APTT显著高于枸橼酸钠组,PLT含量、Cre、BUN含量显著低于枸橼酸钠组(P<0.05)。不同时点比较,2组患者随着时间迁移PT、APTT显著上升,PLT、Cre、BUN含量显著下降。肝素钠组患者导管内抽吸血栓次数、导管功能不良次数显著低于枸橼酸钠组(P<0.05)。肝素钠组患者滤器凝血分级显著优于枸橼酸钠组(P<0.05),滤器和管路使用寿命显著长于枸橼酸钠组(P<0.05)。结论血液透析患者封存Cuff导管时,应用肝素钠的效果相对更好,不良反应发生率也更少。Objective To explore the therapeutic effects and safety of sodium citrate and heparin in maintaining the opening of Cuff catheters in hemodialysis(HMD) patients. Methods A total of 118 HMD patients were randomly divided into sodium citrate group(n=59) and heparin sodium group(n=59).The blood coagulation function and the content of serum biochemical indexes of the patients in both groups before and after treatment were compared. Moreover, the catheter dialysis time, the number of occurrence of CRIs, the number of intraductal sucking blood clots, the number of catheter dysfunction and the filter blood coagulation classifications of the patients of the patients were compared between the two groups. Results After treatment, there were significant difference in the levels of PT, APTT, PLT, Cre and BUN between the two groups(P<0.05). The levels of PT and APTT in heparin sodium group were significantly higher than those in sodium citrate group,however, the levels of PLT, Cre and BUN were significantly lower than those in sodium citrate group(P<0.05). Moreover, the levels of PT and APTT in both groups were increased significantly, whereas the levels of PLT, Cre and BUN were decreased significantly over time. Furthermore, the frequency of intraductal sucking blood clots and the frequency of catheter dysfunction in heparin sodium group were significantly lower than those in sodium citrate group(P<0.05). In addition, the filter blood coagulation grade in heparin sodium was significantly better than that in sodium citrate group. And the service life of the filter and pipeline in heparin sodium group was significantly longer than that in sodium citrate group(P<0.05).Conclusion Heparin sodium is more effective, with less adverse reactions when the Cuff is sealed in HMD patients.

关 键 词：肝素钠 枸橼酸钠 血液透析 CUFF导管 

分 类 号：R459.52[医药卫生—治疗学]