D-二聚体升高的老年患者深静脉置管封管肝素液的浓度

Optiomal Concentration of D-dimer in Elevating Anticoagulant Heparin in Elderly Patients

目的探讨D-二聚体升高的重危老年患者深静脉置管过程中封管肝素液的最佳浓度。方法采用历史对照的方法,2006年1月至2008年6月的85例老年患者作为对照组,2008年7月至2010年12月的90例患者作为观察组,两组患者的血浆D-二聚体水平均大于0.342mg/L。对照组采用25U/ml的肝素液进行深静脉置管封管,观察组则为125U/ml,比较两组患者的堵管发生率及置管时间等。结果观察组堵管发生率低于对照组,计划拔管的比例高于对照组,置管时间长于对照组,差异均有统计学意义(P<0.01)。结论采用125U/ml的肝素液对D-二聚体升高的老年患者进行深静脉置管封管,能有效降低堵管的发生率,延长深静脉置管的使用时间;而更换深静脉管道告知书的使用能有效规避置管纠纷的发生。

Objective To explore the optimal concentration of D-dimer in elevating the sealed tube of high-risk elderly patients with deep venous catheter heparin solution.Methods Using historical controls,85 elderly patients from January 2006 to June 2008 were selected as control group and 90 patients from July 2008 to December 2010 were selected as observation group.The plasma D-dimer levels in both groups were higher than 0.342 mg / L.The patients in the control group and the observation group were sealed 25 U / ml and 125 U/ml heparin solution for deep venous catheter respectively.The incidence of tube cramming and catheter time were compared between the two groups.Results The incidence of blocked tubes in the observation group was significantly lower than that in the control group;The planned extubation in the observation group was significantly higher than that in the control group;The catheter duration in the observation group was significantly longer than that in the control group（P0.01）.Conclusion Sealed tube elevated by D-dimer with 125 U / ml heparin solution in elderly patients with deep venous catheter can effectively reduce the incidence of plugging,extend the time of the deep venous catheter use.The informed book of replacement of deep vein pipeline can effectively avoid the occurrence of catheter disputes.