低分子肝素在伴活动性出血患者血透中的应用

Application of LMWH in Patients with Active Bleeding during Hemodialysis

目的 :观察低分子肝素 (LMWH)在伴有各种活动性出血患者血透中的应用。方法 :采用LMWH在透析开始一次性注入。结果 :(1)各种活动性出血患者临床表现在血透期间和血透后无加重 ;(2 )穿刺点压迫时间短 ;(3)透析管道及透析器复用优于常规肝素化的透析器 ;(4 )透析前后凝血时间、凝血酶原时间、血小板计数无明显变化 (P >0 .0 5 )。结论 :LMWH是一种较为理想的抗凝剂 ,尤其对有出血倾向及有活动性出血的HD患者不失为首选抗凝剂。

Objective: To observe the effects of low molecular weight heparin (LMWH) during hemodialysis in HD patients with active bleeding. Methods: An intravenous injection of LMWH (fraxiparine) was made prior to administration of hemodialysis. Results: Patients with various kinds of active bleeding didn't deteriorate both in the process of hemodialysis and post hemodialysis. The pressing course at the puncture point was short. Dialyzing tubes and dialyzers had a higher rate of repeated use than conventional heparinigation ; CT, PT and PC didn't have any significant changes (P>0.05) both before and after hemodialysis. Conclusion: LMWH is an ideal anticoagulant for HD, which is of first choice in particular for patients with a bleeding tendency and active bleeding .