两种不同护理方案用于无肝素血液透析的比较

Comparement of two nursing methods in the process of hemodialysis without heparin

目的探讨无肝素血液透析的护理策略。方法对28例伴有高危出血的维持性血液透析患者随机分为A、B两组,均给予无肝素血液透析。A组护理方法为:使用14G穿刺针,血流量200～230ml/min,透析前用含肝素3000U/ml的生理盐水预冲后再用生理盐水冲洗透析器和管路,透析中每间隔60min使用生理盐水200ml冲洗透析器。B组方法为:使用16G穿刺针,血流量250～300ml/min,透析前用含肝素3000U/ml的生理盐水预冲并保留15min后再用生理盐水冲洗透析器和管路,透析中每间隔30min使用生理盐水100ml冲洗透析器,比较两组每次透析后透析器的凝血状况和透析器容量。结果B组透析器透析后凝血程度少于A组,透析后平均容量大于A组。结论使用较大号穿刺针、提高血流量、透析前使用肝素盐水浸泡透析器以及增加透析中生理盐水的冲洗次数可以改善透析器的凝血状况,提高透析器的使用率。

Objective: To discuss the nursing maneuver of hemodialysis without heparin.Methods: 28 patients with high risk hemorrhage in need of sustained hemodialysis were divided into two groups(A and B)randomly,all patients were administrated hemodialysis without heparin. In group A,14G penetrate needle were used,blood flow volume were controlled at 200~230ml / min,a preliminary cleans with normal chloride (with heparin of 3000U / ml)were given followed by washing the dialysis machine and the canal with normal chlor...