两种不同预冲管路方法在无肝素CRRT治疗的临床比较研究

Comparative Research on Efficacy and Salty of Pre- washing with Heparin or no in Heparin- free Continuous Renal Replacement Therapy

目的：对比在无肝素CRRT治疗中，使用肝素预冲管路与不使用肝素预冲管路对单次滤器及管路使用时间的影响，对患者的出血并发症，凝血功能、血红蛋白、血小板数值的影响。方法：将我院重症监护室2008年1月至2010年9月需要行无肝素CRRT治疗的患者72例随机分为观察组和对照组，观察组使用合肝素12．5u／ml生理盐水3000m1预冲管路并放置30分钟，再用生理盐水1000ml冲洗管路后行CRRT，对照组使用生理盐水3000ml预冲管路，冲洗完毕后直接行CRRT。将两组更换管路、滤器次数、患者治疗前后凝血功能、血液指标进行统计学比较。结果：两组更换管路和滤器次数，两组病例出血并发症及对比凝血四项数值比较，P〉0．05，差异无统计学意义。结论：无肝素预冲管路对无肝素CRRT单次管路和滤器使用时间无影响，对患者的凝血功能、血液指标无影响。无肝素预冲更节约成本和时间，适合临床推广。

Objective：To investigate the effect of the time of single filters and pipes use and the bleeding complications, coagulation,hemoglobin, platelet values of patients in the pre-washing with heparin or no in heparin-free in continuous renal replacement therapy （CRRT）. Methods：The 72 patients in ICU were randomly divided into two groups,observation group：pipeline were pre- washed firstly with 0.9% saline water and lastly heparin （12.5u/ml）, control group：pipeline were pre-washed with 0.9 % saline water alone. The replacement of pipes, filter frequency, and platelet values etc were analysed and compared with SPSS. Results： No difference were found at each value between two groups（P〉0.05）. Conclusion：The two methods of pre-washing in heparin-free CRRT have no difference in efficacy and safty,no heparin way was more practical for its cost.