肝素钠与枸橼酸钠封管液在ICU患者中心静脉导管封管中的应用及对凝血指标的影响  

The Application of Heparin Sodium and Sodium Citrate Sealing Solution in Central Venous Catheter Sealing of ICU Patients and Its Impact on Coagulation Indicators

作　　者：洪美玉 HONG Meiyu(ICU of Jinjiang Hospital(Fujian Hospital of Shanghai Sixth People's Hospital),Jinjiang 362216,China)

机构地区：[1]晋江市医院(上海市第六人民医院福建医院)ICU,晋江362216

出　　处：《中国医药指南》2024年第18期99-102,共4页Guide of China Medicine

摘　　要：目的探讨肝素钠与枸橼酸钠封管液在ICU患者中心静脉导管封管中的应用及对凝血指标的影响。方法选取2020年9月至2023年10月我院ICU内接受中心静脉行血液透析治疗的87例患者为研究对象,经随机非盲法分组,即对照组(43例,肝素钠溶液进行封管)及观察组(44例,枸橼酸钠封管液)。比较组间凝血指标、不良事件发生情况及封管效果。结果组间血小板计数(PLT)、凝血时间(TT)、活化部分凝血活酶时间(APTT)、凝血酶原时间(PT)、纤维蛋白原(FIB)、血红蛋白(HGB)等凝血指标对比可见,观察组除TT(20.94±6.92)s、PT(19.04±3.29)s、APTT(39.99±3.29)s高于对照组外,PLT、FIB、HGB指标均低于对照组,数据差异有统计学意义(P<0.05);观察组导管堵塞、导管相关感染、穿刺点血肿及渗血、低钙血症的发生率9.09%低于对照组27.91%,组间数据差异有统计学意义(P<0.05);观察组封管效果中留置针留置5 d以上(68.18%)、封管后再通率(95.45%)高于对照组(46.51%、79.07%),而其反复穿刺(4.54%)、堵塞(6.82%)发生率低于对照组的(18.60%、27.91%),组间数据差异有统计学意义(P<0.05)。结论在ICU患者中心静脉导管封管中应用枸橼酸钠封管液进行封管各凝血指标得到改善,封管效果理想且安全可靠。Objective To explore the application of heparin sodium and sodium citrate sealing solution in central venous catheter sealing in ICU patients and their impact on coagulation indicators.Methods Eighty-seven patients who received central venous hemodialysis treatment in the ICU of our hospital from September 2020 to October 2023 were selected as the study subjects.They were randomly and non blinded into a control group(43 cases,sealed with heparin sodium solution)and an observation group(44 cases,sealed with sodium citrate solution).Compare coagulation indicators,incidence of adverse events,and sealing effects between groups.Results The indexes of PLT,FIB and HGB in observation group were lower than those in control group except that TT(20.94±6.92)s,PT(19.04±3.29)s and APTT(39.99±3.29)s were higher than those in control group,and the difference was statistically significant(P<0.05).The incidence of catheter blockage,catheter-related infection,puncture point hematoma,oozemia and hypocalcemia in the observation group was 9.09%lower than that in the control group(27.91%),with statistical significance between groups(P<0.05).In the observation group,the retention of indwelling needles for more than 5 days(68.18%)and the rate of recanalization after sealing(95.45%)were higher than those in the control group(46.51%,79.07%),while the incidence of repeated puncture(4.54%)and blockage(6.82%)was lower than that of control group(18.60%,27.91%).There was significant difference between groups(P<0.05).Conclusions The application of sodium citrate sealing solution in central venous catheter sealing in ICU patients has improved various coagulation indicators,and the sealing effect is ideal and safe and reliable.

关 键 词：血液透析 肝素钠 枸橼酸钠 封管液 中心静脉导管 凝血指标 

分 类 号：R459.5[医药卫生—治疗学]