应用不同浓度的肝素盐水封管预防血液透析导管堵塞的临床研究

Using the different heparinized saline to fill the dead space of each catheter lumen for preventing intracatheter thrombosis

目的探讨应用合理浓度的肝素盐水进行封管,达到有效的防止导管堵塞,减少肝素的用量及其副作用。方法选择广东省佛山市第二人民医院血液净化中心行深静脉留置导管的患者,应用不同浓度肝素盐水对深静脉血液透析导管进行封管,A组(25mg/ml的肝素盐水),B组(12.5mg/ml的肝素盐水),观察两组导管堵塞情况、插管部位出血和全身其他部位出血情况。结果A组30例,导管留置时间(27.00±4.50)d,导管动脉端堵塞4例。B组35例,导管留置时间(26.00±3.50)d,导管动脉端堵塞5例。两组比较P>0.05,差异无显著性。插管部位出血:A组8例,B组2例,B组明显少于A组,P<0.05,差异有显著性。全身其他部位出血情况两组比较差异无显著性。结论应用12.5mg/ml的肝素盐水对深静脉血液透析导管封管,能有效防止导管腔阻塞,减少插管部位出血。

Objective To investigate using the reasonable heparinized saline to fill the dead space of each catheter lumen for preventing intracatheter thrombosis, reducing the dosage and the side effect, of heparin. Methods Using the different heparinized saline to fill the catheter lumens, A group （25mg/ml）, B group （12.5mg/ ml）. Intracatheter thrombosis and the venipuncture export bleeding or other bleedings were observed. Results A group had 30 patients, the time of using the catheter was （27.00±4.50） days, the catheter arterial lumens of 4 patients were obstructed. B group had 35 patients, the time of using the catheter was （26.00±3.50） days, the catheter arterial lumens of 5 patients were obstructed. There was no significant difference on Intracatheter thrombosis within A and B group, P 〉 0.05. The numbers of the venipuncture export bleeding ： A group had 8 patients, B group had 2 patients. B group was significant fewer than A group, P 〈 0.05. The numbers of other bleedings were similar in both groups, P 〉 0.05. Conclusion Using 12.5mg/ml heparinized saline to fill the dead space of each catheter lumen for preventing intracatheter thrombosis is efficient. The venipuncture export bleedings are fewer.