血液保存液在高危出血风险患者间断性血液透析中的应用效果  

Application effect of blood preservation solution in intermittent hemodialysis in patients with high risk of bleeding

作　　者：林样珍 黄晓灵 骆兆健 LIN Yangzhen;HUANG Xiaoling;LUO Zhaojian(Hemodialysis Center,Department of Nephrology,Jiangmen Central Hospital,Guangdong Province,Jiangmen529030,China;Department of Critical Medicine,Jiangmen Central Hospital,Guangdong Province,Jiangmen529030,China)

机构地区：[1]广东省江门市中心医院肾脏内科血液透析中心,广东江门529030 [2]广东省江门市中心医院重症医学科,广东江门529030

出　　处：《中国当代医药》2022年第19期49-52,共4页China Modern Medicine

摘　　要：目的探讨血液保存液在高危出血风险患者间断性血液透析中的应用效果。方法选择2020年10月至2021年6月在江门市中心医院接受间断性血液透析且具有高危出血倾向的96例患者作为研究对象,采用随机数字表法将患者分为观察组和对照组,各48例。对照组采用改良无肝素抗凝,观察组采用血液保存液两段式抗凝。比较两组治疗前后的pH值、血钠、血钾、游离钙水平及凝血活酶时间,评估两组的抗凝效果,并记录两组的并发症发生情况。结果观察组的透析器和静脉壶凝血有效率均高于对照组,差异有统计学意义(P<0.05)。治疗后,两组的游离钙水平比较,差异无统计学意义(P>0.05);观察组治疗后的pH值、血钠水平高于对照组,血钾水平低于对照组,凝血活酶时间短于对照组,差异有统计学意义(P<0.05)。观察组的不良反应总发生率低于对照组,差异有统计学意义(P<0.05)。结论相较于改良无肝素抗凝,在高危出血风险患者间断性血液透析治疗中,两段式血液保存液抗凝可以显著提高抗凝效果,减少不良反应,具有更好的安全性与可靠性。Objective To explore the application effect of blood preservation solution in intermittent hemodialysis in patients with high risk of bleeding.Methods A total of 96 patients with high risk of bleeding tendency who underwent intermittent hemodialysis treated into Jiangmen Central Hospital from October 2020 to June 2021 were selected as the research objects,and the patients were divided into the observation group and the control group according to random number table method,with 48 cases in each group.The control group was treated with modified heparin free anticoagulation,and the observation group was treated with two-stage anticoagulation with blood preservation solution.The pH value,and the levels of blood sodium,blood potassium,free calcium and thromboplastin time before and after treatment were compared between the two groups,the anticoagulant effect in the two groups was evaluated,and the complications in the two groups were recorded.Results The effective rate of dialyzer and venous kettle coagulation in the observation group were higher than those in the control group,and the differences were statistically significant(P<0.05).After treatment,there was no significant difference in the level of free calcium between the two groups(P>0.05).The pH value and the levels of blood sodium level in the observation group after treatment were higher than those in the control group,and the blood potassium level in the observation group was lower than those in the control group,the thromboplastin time in the obsertation group was shorter than that in the control group,and the differences were statistically significant(P<0.05).The total incidence of adverse reactions in the observation group was lower than that in the control group,and the difference was statistically significant(P<0.05).Conclusion Compared with the improved heparin free anticoagulation,two-stage blood preservation solution anticoagulation can significantly improve the anticoagulation effect,reduce adverse reactions,and have better safety and reliability in

关 键 词：间断性血液透析 血液保存液 两段式 高危出血风险 抗凝效果 

分 类 号：R459.5[医药卫生—治疗学]