摘要
目的:观察低分子量肝素-速避凝在高危出血倾向患者血透中应用的疗效和安全性;方法:103例高危出血倾向急、慢性肾衰患者,3075IU aXa速避凝透析前静注。15例稳定的血透患者作为对照组,应用未分组肝素(UFH);结果:速避凝组剂量为59±7(51～65)IU aXa/kg,透析器凝血显著较少;透析2h、4h血浆PATT明显延长,但显著较UFH组短;内瘘穿刺点压迫止血时间显著较短。LMWHs组1例(0.97％)原有消化道出血加重,2例(1.9％)出现皮肤瘀斑,3例(2.9％)穿刺点压迫止血时间延长;结论:速避凝应用于高危出血倾向患者血透具有较好的抗栓作用和安全性,但仍需注意出血并发症,剂量应个体化。
Object: To observe the efficacy and safety of low molecular weight heparin (Fraxiparine) in hemodialysis patients at high risk of bleeding. Methods: one hundred and three patients with acute or chronic renal failure at high risk of bleeding undergoing hemodialysis were evaluated. Fraxiparine of 3075 IU aXa was given intravenously as a single predialysis bolus. Fifteen stable maintanence hemodialysis patients with unfractionated heparin (UFH) were served as the control group. Results: The dosage of Fraxiparine were 59±7(51-65)IU aXa/kg. Less clot formation in dialyzer, shorter pressure time at the puncture sites were observed in Fraxiparine than in UFH one. Significant prolonged plasma APTT 2h and 4h after the dose in Fraxiparine group but significantly shorter than in UFH one. Adverse effects included petechina (1. 96 %) and prolonged pressure time at the puncture sites (2. 94 %). Conclusion: Fraxiparine has a good antihrombotic effecacy in hemodiaysis patients at high risk of bleeding. The dosage must be individulized to avoide bleeding complication.
关键词
低分子量肝素
血液透析
肾功能衰竭
出血
预防
low molecular weight heparin hemodialysis kidney failure, acute or chronic
