无肝素抗凝连续血液净化对ICU脓毒血症患者凝血功能及肾功能的影响  

Effects of heparin-free anticoagulant continuous blood purification on coagulation function and renal function in ICU patients with sepsis

作　　者：张俊勇 裴亮 周平 ZHANG Junyong;PEI Liang;ZHOU Ping(Department of Emergency,Xinyu People's Hospital,Xinyu,Jiangxi,338000,China)

机构地区：[1]新余市人民医院急诊科,江西新余338000

出　　处：《当代医学》2022年第21期5-8,共4页Contemporary Medicine

摘　　要：目的 探讨无肝素抗凝连续血液净化(CBP)对ICU脓毒血症患者凝血功能及肾功能的影响。方法 选取2019年6月至2021年1月本院ICU收治的60例脓毒血症患者作为研究对象,采用简单随机法分为对照组和观察组,每组30例。两组患者进行CBP期间,对照组行低分子肝素抗凝治疗,观察组行无肝素抗凝治疗。比较两组临床疗效、凝血功能水平、肾功能指标及血清炎症因子水平。结果 治疗后,观察组治疗总有效率为93.33%,明显高于对照组的73.33%(P<0.05)。治疗后,两组凝血酶时间(TT)、凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)水平均短于治疗前,纤维蛋白原(FIB)水平低于治疗前,且观察组TT、PT、APTT水平均短于对照组,FIB水平低于对照组(P<0.05)。治疗后,两组血肌酐(SCr)、血尿素氮(BUN)和血栓前体蛋白(TpP)水平低于治疗前,且观察组明显低于对照组(P<0.05)。治疗后,两组白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)水平均明显低于治疗前,且观察组低于对照组(P<0.05)。结论 无肝素抗凝CBP治疗ICU脓毒血症患者疗效良好,可明显改善患者的凝血功能和肾功能,值得临床推广应用。Objective To explore the effects of heparin-free anticoagulant continuous blood purification(CBP) on coagulation function and renal function in ICU patients with sepsis. Methods A total of 60 patients with sepsis admitted to ICU of our hospital from June 2019 and January 2021were selected as the research subjects, and they were divided into control group and observation group according to simple random method, with 30cases in each group. During CBP, control group was given low molecular weight heparin anticoagulation therapy, while the observation group was given heparin-free anticoagulation therapy. The clinical efficacy, the levels of coagulation function, renal function indexes and the levels of serum inflammatory factors were compared between the two groups. Results After treatment, the total effective rate of the observation group was 93.33%,which was significantly higher than 73.33% of the control group(P<0.05). After treatment, the thrombin time(TT), prothrombin time(PT) and activated partial thromboplastin time(APTT) in two groups were shorter than before treatment, the levels of fibrinogen(FIB) lower than before treatment, and the TT, PT and APTT in the observation group were shorter than control group, the levels of FIB in the observation group was lower than the control group(P<0.05). After treatment, the levels of serum creatinine(SCr), blood urea nitrogen(BUN) and thrombus precursor protein(TpP)in two groups were lower than before treatment, and the observation group was significantly lower than the control group(P<0.05). After treatment,the levels of interleukin-6(IL-6) and tumor necrosis factor-α(TNF-α) in two groups lower than before treatment, and the observation group were significantly lower than the in control group(P<0.05). Conclusion Heparin-free anticoagulant CBP has good curative effect in the treatment on ICU patients with sepsis, which can significantly improve coagulation function and renal function and it is worthy of clinical promot.

关 键 词：无肝素抗凝连续血液净化 脓毒血症 凝血功能 肾功能 

分 类 号：R459.7[医药卫生—急诊医学]