低剂量肝素在血液灌流串联血液透析滤过中的临床应用

The Effects of Low Doses Heparin in Hemoperfusion Combined with Hemodiafiltration

目的:研究低剂量肝素在血液灌流串联血液透析滤过治疗合并出血倾向的急性中毒患者时的应用。方法:选择54例患者,治疗组24例用低剂量肝素,对照组30例用常规剂量肝素,在内科综合治疗的基础上,应用HP串联HDF治疗合并出血倾向的急性中毒患者。观察患者治疗前后血压、呼吸、心率、氧饱和度、意识、尿量、瞳孔,血常规,肝、肾功能,PT、APTT等指标的变化,记录患者出血性不良事件的发生。结果:治疗组出血性不良事件发生率明显下降,通道内凝血发生率无显著差异。结论:在血液灌流串联血液透析滤过治疗合并出血倾向急性中毒患者时应用低剂量肝素能够减少出血性不良事件发生,不增加通道内凝血发生,提高患者生存率,此法安全,有效,值得推广。

Objective：To investigate the effects of low doses heparin in hemoperfusion combined with hemodiafiltration treatment acute poisoning with hemorrhagic tendency.Methods：Fifty-four inpatients with bleeding tendency were divided into two groups,which consisted of 24 cases as the treated group treated by low doses heparin in hemoperfasion combined with hemodiafiltration and 30 cases of the control group were treated by routine heparin.Hemorrhagic adverse event,channel clotting incidence and the changes of blood pressure,breath,Heart rate,oxygen saturation, consciousness,urine,blood routine,pupil,PT APTT, liver and kidney function before and after treatment were observed. Results：Treatment group hemorrhagic adverse event rate decreased obviousiy.Channel clotting incidence no significant differences. Conclusion：low doses heparin used in hemopeffusion combined with hemodiatiltration treated acute poisoning with bleeding tendency reduced incidence of aderse events hemorrhagic obviously and improved patient surial safely and effectively