探讨利用活化凝血时间监测进行血液透析过程普通肝素用量调整

To Explore the Monitor Excitation Blood Coagulation Time Adjust to Dosage of Unfractionated Heparin in Hematodialysis Process

目的普通肝素是血液透析中常用的抗凝剂,使用剂量主要依据患者的症状及医生的经验,无法进行科学的数据评量。方法选取30位使用普通肝素的长期血透析患者,使用Hemochron 801凝血测试仪进行活化凝血时间的床边监测。结果肝素用量调整由66.6降至62.2IU/kg,活化时间由活化时间由(1.76±0.32)倍^(1.52±0.28)倍至(1.57±0.48)倍^(1.44±0.28)倍基础值,P<0.05,差异具有统计学意义。结论利用ACT测试可明确个体的肝素感受性及代谢速率差异,合理调整剂量以达到最佳化的肝素治疗效果,降低出凝血的风险,提供安全有效的血液透析治疗方案。

Objective Unfractionated heparin is commonly used anticoagulant in hemodialysis, the dose mainly based on patients symptoms and the experience of doctors, it has no scientiifc data assessment.Methods Selected 30 cases with long-term hemodialysis who had used unfractionated heparin, coagulation used Hemochron 801 tester activated clotting time bedside monitoring.Results The adjusted by the amount of heparin from 66.6 dropped 62.2 IU/kg, Activation time of （1.76±0.32）times, （1.52±0.28） baseline down to （1.57±0.48）times, （1.44 ± 0.28） times the baseline value, P〈0.05, had difference statistically significance.Conclusion ACT test sensitivity and heparin can understand individual differences in metabolic rate, reasonable adjustments to achieve the best of heparin, to avoid the risk of bleeding and clotting, provide safe and effective hemodialysis treatment.