低浓度肝素稀释液用于肝硬化患者套管针封管的临床研究  

Clinical study of low concentration of heparin diluted solution for trocar sealing in patients with cirrhosis

作　　者：汤娟[1] 刘爱莲[1] 张肃 温莹浩[1] TANG Juan;LIU Ailian;ZHANG Su;WEN Yinghao(Pingxiang People′s Hospital in Jiangxi Province,Pingxiang 337000,China)

机构地区：[1]江西省萍乡市人民医院,江西萍乡337000

出　　处：《中国现代医生》2022年第6期189-192,196,共5页China Modern Doctor

基　　金：江西省卫生计生委科技计划(20177197)。

摘　　要：目的 探讨三种低浓度肝素稀释液用于套管针封管对肝硬化患者出凝血机制的影响及最佳的封管液浓度。方法 2018年1月至2020年1月入住江西省萍乡市人民医院消化科的97例肝硬化患者,按照随机数字表法分为A、B、C三组,其中A组32例、B组31例、C组34例,肝素钠稀释液封管分别采用6.25 U/ml、12.50 U/ml、25.00 U/ml,比较三组患者置管前后的出凝血功能、导管堵塞发生率及导管留置时间。结果 三种浓度的肝素稀释液对出凝血功能无影响。三组的封管后导管堵塞率比较,差异有统计学意义(P<0.05),经两两比较,C组的导管堵塞率低于A组(P=0.004);三组的封管后导管留置时间比较,差异有统计学意义(P<0.05),其中C组的4 d留置率为76.47%,三组患者封管后静脉输液通畅情况比较,差异有统计学意义(P<0.05);三组患者拔管时的穿刺口渗漏、红肿、疼痛等不良反应的发生率比较,差异均无统计学意义(P>0.05)。三组患者置管前、停用肝素稀释液封管24 h后的血浆凝血酶原时间(PT)、血浆部分凝血活酶时间(APTT)、血浆纤维蛋白原(FBG)及血小板计数(PLT)的情况比较,差异均无统计学意义(P>0.05)。结论 应用25.00 U/ml肝素钠稀释液用于肝硬化患者套管针封管安全性好,堵管发生率低,导管使用时间长。Objective To investigate the optimal concentration of heparin sealing fluid for trocar sealing in patients with cirrhosis. Methods A total of 97 cirrhotic patients who were admitted to the Department of Gastroenterology of our hospital from January 2018 to January 2020 were divided into three groups by the random number table method:group A with 32 patients in it, group B with 31 patients in it and group C with 34 patients in it. Group A, group B and group C were sealed with 6.25 U/ml, 12.50 U/ml and 25.00 U/ml heparin sodium diluted solution, respectively. The platelet count, plasma prothrombin time(PT), activated partial thromboplastin time(APTT), plasma fibrinogen(FBG)were compared before and after catheterization in the three groups. The incidences of catheter blockage and indwelling time in each group were compared. Results No statistically significant differences were observed in the platelet count,PT, APTT and FBG among the 3 groups before and after catheterization(P>0.05). The catheter blockage rates after sealing were statistically significantly different among the three groups(P<0.05). The catheter blockage rate in group C was lower than that in group A by the pairwise comparison(P=0.004). The indwelling time of catheter after sealing were statistically significantly different among the three groups(P<0.05), and the 4-day indwelling rate of group C was76.47%. There was statistical significance in the patency of venous infusion after tube sealing among the three groups(P<0.05). There was no statistical significance in the incidence of puncture orifice leakage, redness, pain and other adverse reactions during extubation among 3 groups(P>0.05). There were no significant differences in plasma prothrombin time(PT), plasma partial thrombin time(APTT), plasma fibrinogen(FBG) and platelet count(PLT) among 3 groups before catheterization and 24 h after heparin dilution was stopped and catheterization was closed(P>0.05). Conclusion The use of 25.00 U/mL heparin sodium dilution for trocar sealing in patients with

关 键 词：肝硬化 套管针 肝素 留置时间 

分 类 号：R575.2[医药卫生—消化系统] R472[医药卫生—内科学]