重症肝炎患者血浆滤过透析中不同剂量封管液的效果比较  

Comparison of the effects of different doses of sealing solution on plasma dialysis-filtration in patients with severe hepatitis

作　　者：张芳[1] 喻蓉艳[1] 樊霞 胡奕婷 胡家旭 罗玥 黄震 ZHANG Fang;YU Rongyan;FAN Xia;HU Yiting;HU Jiaxu;LUO Yue;HUANG Zhen(The Second Affiliated Hospital of Nanchang University,Nanchang,330006,China)

机构地区：[1]南昌大学第二附属医院感染性疾病科,江西省南昌市330006

出　　处：《护理实践与研究》2023年第22期3334-3338,共5页Nursing Practice and Research

基　　金：江西省卫生健康委科技计划项目(编号:202130427)。

摘　　要：目的对比分析不同肝素浓度封管液在重症肝炎患者行血浆滤过透析(PDF)治疗中的应用效果。方法选取2022年1—12月于医院接受PDF治疗的重症肝炎患者180例为研究对象。按照组间资料均衡可比的原则将患者分为高浓度组、低浓度组和微小浓度组,每组60例。所有组均采用PDF治疗,高浓度组采用5000 U/ml和10000 U/ml肝素钠封管液,低浓度组采用1000 U/ml和10000 U/ml肝素钠封管液,微小浓度组采用12.5 U/ml和25 U/ml肝素钠封管液。比较三组患者PDF前、后血浆凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、国际标准化比值(INR)的变化及三组患者平均封管时间、出血趋向评分、上机前导管通畅度评分、治疗期间不良事件、导管相关感染发生情况。结果进行PDF治疗前,三组患者PT、APTT、INR指标比较差异无统计学意义(P>0.05);PDF治疗后,三组患者PT、APTT、INR指标均低于干预前,但三组患者PDF治疗后PT、APTT、INR指标比较差异均无统计学意义(P>0.05)。三组患者平均封管时间、出血风险评分及上机前导管通畅度评分比较,差异无统计学意义(P>0.05)。三组患者治疗期间皮下出血、穿刺点出血、隧道口渗血、血栓形成及导管相关感染等并发症总发生率比较差异均无统计学意义(P>0.05)。结论选择微小浓度组肝素钠封管液同样能保证对重症肝炎行PDF治疗患者的治疗效果,且安全性更高,还可减少肝素钠用量,治疗成本变低。Objective To compare and analyze the application effect of different heparin concentration sealing solutions in plasma dialysis-filtration(PDF)treatment of severe hepatitis patients was as the subject.Methods A total of 180 patients with severe hepatitis who received PDF treatment in hospitals from January to December 2022 were selected as the study subjects.According to the principle of balanced and comparable data between groups,patients were divided into high concentration group,low concentration group,and micro concentration group,with 60 cases in each group.All groups were treated with PDF,the high concentration group was treated with 5000 U/ml and 10000 U/ml heparin sodium sealing solution,the low concentration group was treated with 1000 U/ml and 10000 U/ml heparin sodium sealing solution,and the small concentration group was treated with 12.5 U/ml and 25 U/ml heparin sodium sealing solution.The changes in prothrombin time(PT),activated partial thromboplastin time(APTT),and international normalized ratio(INR)before and after PDF were compared among three groups of patients,as well as the average sealing time,bleeding trend score,preoperative catheter patency score,adverse events during treatment,and incidence of catheter related infections.Results Before PDF treatment,there was no statistically significant difference in PT,APTT,and INR indicators among the three groups of patients(P>0.05);after PDF treatment,the PT,APTT,and INR indicators of the three groups of patients were lower than before intervention,but there was no statistically significant difference in PT,APTT,and INR indicators among the three groups of patients after PDF treatment(P>0.05).There was no statistically significant difference in the average sealing time,bleeding risk score,preoperative catheter patency score among the three groups of patients during treatment(P>0.05).There was no statistically significant difference in the total incidence of complications such as subcutaneous bleeding,puncture point bleeding,tunnel mouth bleeding,thr

关 键 词：重症肝炎 血浆滤过透析 封管液 不同浓度 应用 

分 类 号：R473.5[医药卫生—护理学]