脑梗塞患者静脉留置针封管液选择的探讨

目的观察脑梗塞患者静脉留置针不同封管液对针管堵塞的影响。方法将120例脑梗死患者随机分2组,中年组60例,其中对照组30例,观察组30例;老年组60例,其中对照组30例,观察组30例。对照组患者用0.9%生理盐水3ml,观察组患者用10～100IU/ml肝素钠液2～5ml封管,封管前采肘静脉血8ml,测定总胆固醇、甘油三脂、凝血酶原时间凝血酶原时间比值、纤维蛋白原、凝血活酶时间、凝血酶时间等指标,观察两组静脉封管后血管堵管发生率及与血脂和部分凝血系统各指标变化,并做相关分析。结果经过4天观察,发现中年组和老年组患者,用生理盐水和肝素液封管,血管堵塞的发生率无明显差异(P均>0.05);凝血活酶时间、凝血酶原时间比值,堵塞组均高于无堵组,差异显著(P<0.05);其它各参数2组相比无差异性。凝血活酶时间、凝血酶原时间比值,中年组和老年组中对照组与观察组相比差异显著(P<0.05)。凝血活酶时间、凝血酶原时间比值,堵塞组均高于无堵组,差异显著(P>0.05)。结论脑梗塞患者,无论是中年人还是老年人,用生理盐水和用肝素钠封管,血管堵塞的发生率无明显关系,血管堵塞的发生与凝血活酶时间、凝血酶原时间比值改变关系密切。因此在临床护理工作中,对脑梗塞患者检测凝血活酶时间、凝血酶原时间比值指标变化,对静脉留置针封管液的选择可能有利。

Objective To observe the effect of different tube-sealing solution on needle tube plugging in cerebral infarction patients.Methods 120 cerebral infarction patients were randomly divided into two groups： 60 in middle-aged group and 60 in elderly group;58 in control group and 60 in observation group.Control group was given 3ml 0.9% normal saline,while observation group was given 10-100IU/ml heparin sodium aqua.Patients’ elbow vein blood were 8ml before sealing.Their total cholesterol,three acids glyceride,prothrombin time ratio,f ibrinogen,thromboplastin time and thrombin time were determined and the incidence of tube plugging and the change of blood lipid and some coagulation systems were observed and analyzed.Results The incidence of tube plugging in middle-aged group and elderly group had no obvious difference after observed for 4 days （P〉0.05）;plugging group’s thromboplastin time and prothrombin time ratio were higher than no plugging group,the difference was signifi cant,P〈0.05;two groups’ other parameters had no difference.Control group and observation group’s thromboplastin time and prothrombin time ratio had obvious difference （P〈0.05）,and plugging group was higher than no plugging group,the difference was signif icant （P〈0.05）.Conclusion No matter middleaged people or old people,the incidence of vascular plugging has no obvious difference when they sealed by normal saline or heparin sodium aqua.The incidence of plugging is closely related to thromboplastin time and prothrombin time ratio.We should closely observe the change of those indexes in clinical nursing,which would be helpful to the selection of tube-sealing solution.