连续性肾脏替代治疗中动静脉正接时管路采血检验的可行性  

Clinical study on blood sampling test of regular-connected lines in continuous renal replacement therapy

作　　者：代明金 王芳[1,2] 张凌 陈志文[1,2] 陈雯雯[2] 李洋 DAI Mingjin;WANG Fang;ZHANG Ling;CHEN Zhiwen;CHEN Wenwen;LI Yang(West China School of Nursing, Sichuan University, Chengdu 610041,China;Department of Nephrology of West China Hospital, Sichuan University, Chengdu 610041,China)

机构地区：[1]四川大学华西护理学院,四川成都610041 [2]四川大学华西医院肾脏内科,四川成都610041

出　　处：《西部医学》2020年第5期769-772,共4页Medical Journal of West China

基　　金：四川大学华西医院学科卓越发展1.3.5工程临床研究孵化项目(2018HXFH018);四川大学华西护理学科发展专项基金项目(HXHL19066)。

摘　　要：目的探讨连续性肾脏替代治疗(CRRT)中,当动静脉正接时管路采血代替体内静脉采血的可行性,并分析不同抗凝方式下动静脉正接时管路采血检验对检验结果的影响。方法选取2018年6~12月在四川大学华西医院行CRRT治疗动静脉正接的患者60例,采用自身对照的方式,从患者外周静脉进行采血,同时分别于CRRT机器动脉管路最前端采样口采集血标本(暂停治疗0 min、1 min、3 min、5 min),采集的血标本同时进行酸碱、电解质等检测,对比检验结果,并比较不同抗凝方式下动静脉正接时管路采血对检验结果的影响。结果枸橼酸抗凝正接时,不同暂停治疗时长(0 min、1 min、3 min、5 min)的管路采血、体内静脉采血的各项血气分析指标分别进行组间的两两比较,差异均无统计学意义(P>0.05);低分子肝素与无肝素抗凝正接时,不同暂停治疗时长(0 min、1 min、3 min、5 min)的管路采血、体内静脉采血的各项血气分析指标分别进行多组间的两两比较,差异均无统计学意义(P>0.05)。结论CRRT治疗时,当管路正接情况下,可从管路采血代替体内静脉采血进行血标本检验,且采集时不需要暂停治疗。可为临床CRRT血标本检测提供参考。Objective To explore the feasibility of pipeline blood sampling instead of body venous blood sampling of regular-connected lines and to explore the influence of different anticoagulant methods on the test results in continuous renal replacement therapy(CRRT).Methods 60 patients underwent CRRT treatment in a tertiary hospital from June to December 2018 were enrolled in this study.Blood samples were collected from the peripheral vein of the patient and the foremost arterial sampling port(Stop treatment 0min,1min,3min,5min)in the CRRT machine line,the collected blood samples were tested for acids,alkaloids,electrolytes,etc.,and compared test results.Results In the regular lines,the blood collection parameters of different treatment durations(0min,1min,3min,5min)were compared with the blood gas analysis indexes of venous blood in the body,and there was no statistical difference(P>0.05).Conclusion During CRRT,the blood can be collected from the pipeline instead of the venous blood sampling in the body for blood sample testing,and the treatment is not required to be suspended.The results of this study can provide a reference for clinical CRRT blood sample testing.

关 键 词：管路采血 静脉采血 连续性肾脏替代治疗 血气分析 血液净化 

分 类 号：R692.5[医药卫生—泌尿科学]