摘要
目的寻找治疗有出血危险性患者较为理想的血液透析 (HD)抗凝疗法。方法将 86例次有出血危险性HD患者随机分为三组 ,分别采用匀速同步体外肝素化 (观察组 )、无抗凝剂HD(对照A组 )和全身小剂量肝素化 (对照B组 )抗凝疗法。比较各组透析及抗凝效果 ,抗凝并发症。结果①观察组、对照A组对体内试管法凝血时间 (LWCT)的影响明显小于对照B组 (P <0 .0 0 1) ;②观察组、对照B组透析器 (HFD)内LWCT明显延长 ,能满足HD要求 ,明显优于对照A组 (P <0 .0 0 1) ;③透析充分性指标血尿素氮、肌酐及整体尿素清除率三组差异无显著性 ( P >0 .0 5 ) ;④对照组发生HFD凝血及肝素相关出血并发症共 11例次 ,改为观察组后HD顺利。结论本方法兼有无抗凝剂HD和全身小剂量肝素化的优点 ,并且克服了后二者的某些缺点 ,具有抗凝效果好 ,稳定性强 ,发生凝血和出血并发症少 ,透析效果肯定及操作简便的特点。
ObjectiveTo search the anticoagulant treatment of hemodialysis (HD) more ideal for patients with hemorrhagic risk.MethodsEighty six patients with hemorrhagic risk were divided into 3 groups at random.The patients in the observed group were treated with synchronous and uniformly sped external heparinization(SUSEH);the control group A without anticoagulant;and the control group B with systemic small dose heparinization.The efficacy of HD and anticoagulation as well as the complications of anticoagulant were compared and analyzed.ResultsThe influence on internal Lee White clotting time (LWCT) in observed group and control group A were significantly less than that in the control group B (P<0.001).The LWCT within Hollow fiber dialyzer (HFD) in observed group and control group B were significantly prolonged to satisfy the reguirements of HD than in control group A (P<0.001).The indexes of HD thoroughness such as blood urea nitrogen (BUN) serum creatinine (SCr) and KT/V urea showed no significant difference among 3 groups (P>0.05).Complications of coagulation with HFD and hemorrhage occurred in 11 cases of control groups,but when the patients were treated with SUSEH,HD were successfully performed.ConclusionsSUSEH has the advantages of both the systemic small dose heparinization and HD without anticoagulant,at the same time it overcomes some defects of these two methods.Because of its good anticoagulant effect,considerable stabilitys,less complications of coagulation and hemorrhage,definite effect of HD and easy operation,it can be ideally applied as a better choice for the patiants with hemorrhagic risk.
出处
《湖南医学》
2000年第2期83-85,共3页
Hunan Medical Journal
关键词
肾功能衰竭
血液透析
抗凝药
肝素
kidney failure/therapy
hemodialysis/therapy use
hemorrhagic diathesis/secondary
anticoagulants
