体外局部抗凝技术在出血高风险患者连续性血液净化治疗中的应用  

Application of Extracorporeal Local Anticoagulation Technology in Continu⁃ous Blood Purification in Patients with High Bleeding Risk

作　　者：尹朝阳 杨静 向忠阳 YIN Chaoyang;YANG Jing;XIANG Zhongyang(Department of Critical Care Medicine,the Fifth Division Hospital of Xinjiang Production and Construction Corps,Bole,Xinjiang Uygur Autonomous Region,833400 China;Department of Laboratory Medicine,the Fifth Division Hospital of Xinjiang Production and Construction Corps,Bole,Xinjiang Uygur Autonomous Region,833400 China)

机构地区：[1]新疆生产建设兵团第五师医院重症医学科,新疆博乐833400 [2]新疆生产建设兵团第五师医院检验科,新疆博乐833400

出　　处：《系统医学》2022年第18期58-61,共4页Systems Medicine

基　　金：新疆生产建设兵团第五师双河市科技项目(21YW08)。

摘　　要：目的分析出血高风险患者连续性血液净化治疗中体外局部抗凝技术的应用效果。方法选取2020年5月—2021年4月于新疆生产建设兵团第五师医院接受连续性血液净化治疗存在出血高风险的60例患者,采用单双号方式分组,常规组(n=30)采用生理盐水冲洗抗凝治疗,研究组(n=30)采用体外局部抗凝技术治疗,使用生化检测方式采集电解质、酸碱度、凝血功能等数据,并整理滤器使用时间、出血事件发生率等数据。结果治疗后,研究组的电解质、酸碱度水平凝血功能优于常规组,差异有统计学意义(P<0.05);研究组单个滤器管路使用时长、更换频次、总治疗时间(72.42±8.16)h、(5.75±1.34)次、(15.06±1.72)d,均优于常规组(53.23±10.05)h、(8.60±2.52)次、(16.98±3.92)d,差异有统计学意义(t=8.119、5.469、2.457,P<0.05);研究组出血事件发生率3.33%低于常规组26.67%,差异有统计学意义(χ2=4.706,P<0.05)。结论出血高风险患者连续性血液净化治疗中,体外局部抗凝技术的实施,能够促进患者连续性血液净化期间机体状态稳定,降低出血事件发生率,效果极佳。Objective To analyze the application effect of extracorporeal local anticoagulation in continuous blood purification therapy in patients with high bleeding risk.Methods From May 2020 to April 2021,60 patients with high risk of bleeding who received continuous blood purification therapy in the Fifth Division Hospital of Xinjiang Production and Construction Corps were selected.Grouped by odd and even numbers,routine group(n=30)was given normal saline flushing anticoagulation therapy.Study group(n=30)was treated with in vitro local anticoagulation technology.Data such as electrolytes,pH,and coagulation function were collected using biochemical detection methods.The data of the filter usage time and the incidence of bleeding events were sorted out,and the efficacy analysis was done.Re⁃sults After treatment,the electrolyte,pH levels and coagulation of the study group were better than those of routine group,and the difference was statistically significant(P<0.05);compared with the routine group,the study group had better coagulation function,and the difference was statistically significant(P<0.05);the use time,replacement frequency,and total treatment time of a single filter tube in the study group were(72.42±8.16)h,(5.75±1.34)times,and(15.06±1.72)d,which were all better than those in the routine group(53.23±10.05)h,(8.60±2.52)times,(16.98±3.92)d,the differences were statistically significant(t=8.119,5.469,2.457,P<0.05);the incidence of bleeding events in the study group was 3.33%lower than that in the routine group(26.67%),the difference was statistically significant(χ2=4.706,P<0.05).Conclusion In the continuous blood purification treatment of patients with high bleeding risk,the implementation of extracorporeal local anticoagulation technology can promote the stability of the patient′s body during continuous blood purification,reduce the incidence of bleeding events,and has an excellent effect.

关 键 词：体外局部抗凝技术 出血高风险 连续性血液净化 应用效果 

分 类 号：R459[医药卫生—治疗学]