摘要
目的探究预见性护理干预对维持性血液透析患者血流灌流凝血事件的影响。方法将2014年9月至2015年6月于我院进行血液透析串联血流灌流治疗的78例患者纳入研究对象,随机法分为观察组与对照组,每组39例。对照组进行常规护理,观察组进行预见性护理干预,主要手段为维持合适血流速度、保持充分肝素剂量及增加操作熟练度。分别于透析前、透析结束后测量两组凝血酶原时间(PT)、部分凝血酶原时间(aPTT)、凝血酶时间(TT)、血浆D二聚体、纤维蛋白原(Fbg)及组织纤溶酶原激活物(t-PA)含量,并于治疗期间统计两组凝血事件,划分凝血状况等级,计算严重凝血事件发生率。结果与透析前相比,两组透析后PT、aPTT、TT均明显下降(P<0.05),但透析后观察组各指标均明显高于对照组(P<0.05);透析后,两组D二聚体含量均明显升高,但观察组升高幅度明显低于对照组(P<0.05),与透析前相比,透析后两组Fbg、t-PA均明显下降,但观察组均显著高于对照组(P<0.05);观察组严重凝血发生率为2.56%,与对照组15.38%相比明显降低(P<0.05)。结论对维持性血液透析串联血流灌流治疗的患者实行预见性护理干预,可有效改善其凝血功能异常状况,并显著降低治疗期间严重凝血事件的发生率。
Objective To explore effects of predictive nursing intervention on hemoperfusion coagulation events in patients with maintenance hemodialysis. Methods 78 patients who received hemodialysis tadem hemoperfusion therapy in our hospital from September 2014 to June 2015 were selected as the study subjects, they were divided by random number table into the observation group and the control group （ each 39 cases ）. The control group was given routine nursing, the observation group was given predictive nursing intervention, principal means were maintaining proper blood flow velocity, retaining a sufficient heparin dose, increasing operational proficiency. Prothrombin time （ PT）, partial prothrombin time （ aFFF）, thrombin time （ TF）, plasma D- dimer, fibrinogen （Fbg） and tissue plasminogen activator （ t- PA） content in the two groups were measured before and after the dialysis, coagulation events in the two groups, division of coagulation status during the treatment were recorded, incidence of severe coagulation events were calculated. Results Compared with pre-dialysis, PT, aPTT and TT after the dialysis in the two groups were significantly decreased （ P 〈 0. 05 ）, but after the dialysis, indexes of the observation group were significantly higher than the control group （ P 〈 0. 05 ） ; after the dialysis, content of D- dimer in the two groups were significantly increased, but the observation group ascending range was significantly lower than the control group （ P 〈 0. 05 ） , compared with pre- dialysis, after the dialysis, Fbg and t- PA in the two groups were significantly decreased, but content of the observation group were significantly higher than the control group （P 〈 0. 05 ） ;incidence of severe coagulation in the observation group was 2.56% ,which was significantly lower than the control group（ 15.38% ） （P 〈 O. 05 ）. Conclusion Predictive nursing intervention for patients treated with maintenance hemodialysis tadem hemoperfusion therapy can improve abnormal conditions of coagulation function effectively, and reduce incidence of severe coagulation events.
出处
《血栓与止血学》
2017年第2期330-332,共3页
Chinese Journal of Thrombosis and Hemostasis
关键词
预见性护理
维持性血液透析
血流灌流
凝血
Predictive nursing
Maintenance hemodialysis
Hemoperfusion
Coagulation
