摘要
目的探讨连续性血液净化中高危出血患者采用同步枸橼酸抗凝与无肝素抗凝的应用及护理。方法选择21例高危出血倾向的患者随机分为2组,A组10例采用同步枸橼酸抗凝,行血液净化23例次;B组11例采用无肝素抗凝,行血液净化21例次,监测全血活化凝血时间(WBACT)和PH值、碱剩余(BE)、滤器和管路等指标,比较两种方法的差异,在治疗中怎样对护理问题进行观察及处理。结果 A组患者滤后WBACT较滤前明显延长,而治疗前后WBACT并无明显差异(P>0.05);两组患者滤后与滤前WBACT的延长时间,A组WBACT在2、4及6h的延长时间均明显大于B组(P<0.05);而A组较B组管路使用寿命较长,更换频次较低,肌酐下降率较高(P<0.05),治疗后无碱中毒出现。结论同步枸橼酸抗凝对患者全身凝血状态无明显影响,不加重出血倾向,管路中抗凝效果好,节约了医疗耗材,适用于高危出血患者的治疗。
Objective To discuss the application and nursing of continuous blood purification using synchronous cirtric acid anticoagulation and without-heparin anticoagulation for patients at high risk of bleeding.Methods Patients were divided into two groups.Group A using synchronous cirtric acid anticoagulation,group B using without-heparin anticoagulation.Clinical indice including whole blood activated clotting time（WBACT）,PH value,base excess（BE）,higher serum creatinine decrease rate,service life of the hemofilter and pipelines were compared between the two groups during therapy.Results The WBACT before hemofilter was much longer than that after hemofilter（P0.05）,while no significant difference was found between the WBACT before and after therapy（P0.05）.Group A had longer pipeline life service time,lower replace frequency and higher serum creatinine decrease rate than group B（P0.05）.No alkalosis was found in the cohort.Conclusion Synchronous cirtric acid anticoagulation has no effect on the patients＇ systemic coagulation,and would not increase bleeding risk,has better anticoagulation in pipeline,which is suitable for patients at high risk of bleeding.
出处
《西部医学》
2012年第2期391-393,共3页
Medical Journal of West China
关键词
连续性血液净化
同步枸橼酸抗凝
无肝素抗凝
全血活化凝血时间
Continuous blood purification
Synchronous cirtric acid anticoagulation
Without-heparin anticoagulation
Whole blood activated clotting time
