血液透析的长期深静脉置管肝素浓度1000U/mL与5000U/mL的出血风险对比

Comparison of the Risk of Bleeding Between Heparin Concentration 1000U/mL and 5000U/mL in Long-term Deep Venous Catheterization in Hemodialysis

目的:探讨两种不同浓度的肝素封管应用于血液透析的长期深静脉置管中对患者出血风险的影响。方法:选取本院收治的行血液透析的长期深静脉置管慢性肾功能不全患者42例,按照随机数字表法分为观察组和对照组,每组各21例。观察组用含低浓度肝素钠进行封管,对照组用含高浓度肝素钠进行封管。比较两组出血情况以及不良事件发生率。结果:观察组穿刺压迫点时间、潜血转阴时间和皮肤黏膜出血停止时间均明显低于对照组,差异均有统计学意义(P<0.05);观察组出血发生率明显低于对照组,差异有统计学意义(P<0.05);两组血栓、感染以及拔管发生率比较,差异均无统计学意义(P>0.05)。结论:低浓度肝素钠溶液作为封管液应用于血液透析长期深静脉置管中,效果等同于高浓度肝素钠溶液,且不增加出血风险,能降低不良事件的发生率。

ObjectiveTo investigate the effect of two different concentrations of heparin on the risk of bleeding in patients with long-term venous catheterization in hemodialysis.Method：A total of 42 cases with chronic renal insufficiency performed hemodialysis with long-term venous catheterization in our hospital were selected and divided into the observation group and the control group according to random number table method,21 cases in each group.The observation group was sealed with low concentration heparin sodium（1000 U/mL）,the control group was sealed with high concentration heparin sodium（5000 U/mL）.The conditions of bleeding and the incidence of adverse event of two groups were compared.Result：The puncture pressure time,the occult blood clearance time and the mucocutaneous bleeding time of the observation group were significantly shorter than those of the control group（P〈0.05）;the incidence of bleeding of the observation group was obviously lower than that of the control group（P〈0.05）;there were no statistical significance in the incidence of thrombosis,infection and extubation of two groups（P〉0.05）.Conclusion：In long-term deep venous catheterization in hemodialysis,the low concentration heparin sodium as sealing fluid has the equivalent effect to the high concentration heparin sodium,and do not increase the risk of bleeding,can lower the incidence of adverse event.