ECMO并联CVVHDF一体化治疗重症病人并联导管采血行实验室检查的可行性研究  

Study on feasibility of parallel catheter blood collection for laboratory testing in severe patients treated with ECMO and CVVHDF

作　　者：易金燕[1] 杨丽[1] 钟博华 易紫辉 许伟 林海成 YI Jinyan;YANG Li;ZHONG Bohua;YI Zihui;XU Wei;LIN Haicheng(The First Affiliated Hospital of Guangxi Medical University,Guangxi 530021 China)

机构地区：[1]广西医科大学第一附属医院,广西530021

出　　处：《护理研究》2023年第17期3056-3063,共8页Chinese Nursing Research

基　　金：广西壮族自治区卫生健康委员会自筹经费科研项目,编号:Z20200905。

摘　　要：目的:对比分析体外膜肺氧合(ECMO)并联导管与有创动脉导管中采血的血常规、凝血功能、肝肾功能、电解质水平的差异。方法:选择行ECMO并联连续性静⁃静脉血液透析滤过(CVVHDF)一体化治疗的43例重症病人为研究对象。采用自身对照法,在一体化治疗开始后24、48 h,分别经有创动脉导管、ECMO并联导管采集血液8 mL,对比分析两份血样中血常规、凝血功能、肝肾功能以及电解质水平的差异。结果:经ECMO并联导管与有创动脉导管采血的血常规、凝血功能(纤维蛋白原除外)、肝肾功能、电解质水平比较,差异均无统计学意义(P>0.05)。但经ECMO并联导管采血的纤维蛋白原水平低于有创动脉导管(P<0.05)。结论:可经ECMO并联导管采血用于血常规、大多数凝血功能、肝肾功能以及电解质的检测,不建议经ECMO并联导管采血行纤维蛋白原检测。Objective:To compare and analyze the differences of blood routine,coagulation function,liver and kidney function and electrolyte level between extracorporeal membrane oxygenation(ECMO)parallel catheter and invasive arterial catheter.Methods:A total of 43 severe patients were selected for integrative therapy of ECMO parallel CVVHDF.By self-control method,8 mL of blood was collected 24 h and 48 h after integrative therapy by invasive arterial catheter and ECMO parallel catheter.The two samples were sent to the clinical laboratory of our hospital at the same time,and the differences of blood routine,coagulation function,liver and kidney function and electrolyte level in the two blood samples.Results:There were no significant differences in blood routine,coagulation function(except fibrinogen),liver and kidney function and electrolyte level between ECMO parallel catheter and invasive arterial catheter(P>0.05).But the level of fibrinogen in blood collected by ECMO parallel catheter was lower than that of invasive arterial catheter(P<0.05).Conclusion:Blood collection by ECMO parallel catheter can be used for blood routine,most coagulation function,liver and kidney function and electrolyte detection,but it is not recommended to do fibrinogen detection by ECMO parallel catheter.

关 键 词：体外膜肺氧合 连续性静⁃静脉血液透析滤过 采血 血常规 凝血功能 纤维蛋白原 

分 类 号：R473[医药卫生—护理学]