不同预处理对高凝倾向患者行血液滤过联合灌流治疗的效果评价

Evaluation on the effect of different pretreatment on the treatment for patients with high coagulation tendency by combination of hemofiltration and hemoperfusion

目的探讨采取不同预处理方法高凝倾向患者行血液滤过(Hemofiltration,HF)联合血液灌流(Hemoperfusion,HP)对滤器凝血发生率和灌流治疗完成情况的影响。方法选取我科2014年11月-2015年11月有高凝倾向并需紧急行床旁HF联合HP治疗的患者157例,随机分成观察组81例和对照组76例。两组患者分别采用不同的方式进行血液滤器预处理,观察并分析两组患者滤器凝血程度,灌流治疗完成情况及治疗结束时凝血功能及血常规相关指标的变化。结果 (1)两组滤器的凝血发生率比较差异有统计学意义(P<0.05)。(2)两组灌流治疗完成情况比较差异有统计学意义(P<0.05)。(3)两组患者治疗结束时活化部分凝血活酶(APTT-SEC)、凝血酶原时间(PT-SEC)、凝血酶时间(TT-SEC)等的比较差异均无统计学意义(P>0.05);结论观察组可减少有高凝倾向的重症患者行血液滤过联合灌流治疗时滤器凝血发生率,提高灌流治疗完成率,且对血液相关因子的影响没有临床意义,具有一定临床推广价值。

Objective To investigate the effects of different pretreatment methods on the coagulation rate and the success rate of hemofiltration（ HF） combined with hemoperfusion（ HP） for patients with high coagulation tendency. Methods In our department from November 2014 to November 2015,there were 157 patients with HF combined HP treatment with high coagulation tendency,and patients were randomly divided into two. The experimental group and control group respectively by different ways of blood filter preprocessing was observed and analysis of two groups of patients with filter clotting degree,indexes of coagulation function and blood flow after treatment success rate and treatment change of irrigation.Results（ 1） Control group and experimental group filter clotting rate was statistically significant（ P0.05） 。（ 2） the two groups perfusion treatment success rate compared with statistical significance（ P0.05） 。（ 3） after the end of the treatment,the patients in the two groups activation prothrombin time PT-SEC and partial thromboplastin（ APTT-SEC） thrombin time（ TTSEC） and other showed no statistical significance（ P0.05）; Conclusion The experimental group can reduce the high coagulation tendency of severe patients with hemofiltration combined with hemoperfusion in the treatment of coagulation rate,improve the success rate of perfusion treatment,and the effect of blood related factors has no clinical significance,with clinical value.