摘要
目的探究两种不同的预冲方法对血液灌流（HP）联合血液透析滤过（HDF）治疗中灌流器内凝血的影响。方法选取2011年5月-2013年3月浙江省丽水市人民医院净化科接受HP＋HDF联合治疗的维持性血液透析患者18例，根据患者预冲方式的不同将患者接受的108例次的治疗分为实验组和对照组，对照组76例次采用灌流器和滤器分别单独预冲的方式，实验组32例次采用血路管、灌流器、滤器联合预冲密闭循管的方法进行预冲。统计两组患者的预冲时间、生理盐水使用量、肝素使用量，并比较两种预冲方式引起的灌流器内凝血程度和治疗成功率。结果①实验组预冲时间、生理盐水使用量、肝素使用量分别为（36．7±2．3）min、（1731．9±176．5）mL和（163．4±31．0）mg；对照组为（54．6±3．8）min、（3627．5±189．5）mL和（184．8±25．7）mg，两组比较差异均有统计学意义（P〈0．05）。②实验组凝血程度评级为0、I、Ⅱ级的比例分别为87．5％、9．4％、3．1％，而对照组凝血程度分级比例分别为71．1％、23．7％、5．3％，差异有统计学意义（P〈0．05）。③实验组成功31例，不成功1例，成功率为96．9％；对照组成功58例，不成功18例，成功率为76-3％。两组成功率比较，差异有统计学意义（P〈0．05）。结论联合预冲方式可以有效的减少预冲时间，成本更低，减轻灌流器内凝血程度，是目前较佳的预冲方法，值得在临床上进一步广泛推行。
Objective To investigate two different methods of pre-washed hem perfusion （HP） combined hemodiafiltration （HDF） treatment of coagulation of perfusion. Methods 18 hem dialysis patients with HP＋HDF combination therapy from May 2011 to March 2013 in People＇s Hospital of Lishui City were selected, 108 cases of therapy were divided into experiment group and control group according to the patient reshoot different ways. 76 cases in control group were treated with separate pre-wash of perfusion apparatus and colander, 32 cases in experiment group were treated with combined pre-wash of blood trail pipes, perfusion apparatus and colander. Pre-wash time, physiological saline usage, heparin usage were counted; blood coagulation degree of perfusion apparatus and treatment success rate of the two pre-wash methods were compared. Results （1）Pre-wash time, physiological saline usage, heparin usage of experiment group were （36.7±2.3） min, （1731.9±176.5） mL and （163.4±31.0） rag, the indexes in control group were （54.6±3.8） min, （3627.5±189.5） mL and （184.8±25.7） mg, the differences were statistically significant （P 〈 0.05）. （2）The proportion of 0, I, II grade of blood coagulation degree in experiment group were 87.5%, 9.4%, 3.1%; the proportion of 0, I, II grade of biood coagulation degree in control group were 71.1%, 23.7%, 5.3% respectively, the differences were statistically significant （P 〈 0.05）. （3） cases of success and 1 case of unsuccess were found in experiment group, the successful rate was 96.9%; 58 cases of success and 18 cases of unsuccess were found in control group, the successful rate was 76.3%. The difference of successful rate in the two groups was statistically significant （P 〈 0.05）. Conclusion Combined pre-wash can effectively reduce the pre-wash time, costs and blood coagulation degree of perfusion apparatus, it is the good pre-wash method, it is worthy of clinical promotion.
出处
《中国医药导报》
CAS
2013年第31期144-146,150,共4页
China Medical Herald
基金
教育部"高等学校博士学科点专项科研基金"联合资助项目(编号200802280003)
