普通肝素剂量调整在连续性血液净化中的应用及护理

Application of unfractionated heparin dose adjustment in continuous blood purification and nursing care

目的探究普通肝素剂量调整在连续性血液净化中的应用效果及护理措施。方法选取2014年1月～2017年1月，到浙江省立同德医院进行连续性血液净化治疗的94例患者，按照时间先后，将患者分为观察组（n=47）和对照组（n=47），所有患者均采取连续性血液净化治疗，对照组患者肝素首剂1000u，持续500u/h量不变；观察组患者肝素首剂1000u，初始维持量500u/h，随后每4h调整一次肝素用量；对比2组患者的治疗效果。结果观察组治疗时间（23.73±18.97）h明显高于对照组（16.28±10.74）h（P＜0.05）；观察组滤器凝血例数明显少于对照组，有统计学意义（P＜0.05）。与实验组相比，经过治疗后对照组滤器出现凝血的例次更多，2组差异显著（P＜0.05），穿刺点压迫平均时间差异不显著，不具有统计学意义。说明实验组体外抗凝效果较对照组好。结论在连续性血液净化中调整普通肝素剂量能够延长治疗时间，提升治疗效果，延长滤器寿命，具有较高的应用价值。

Objective To explore the application effect and nursing measures of unfractionated heparin dose adjustment in continuous blood purification.Methods From January2014to January2017in our hospital,continuous blood purification treatment of94cases of patients,according to the time sequence,the patients were divided into observation group(n=47)and control group(n=47),all patients were treated by continuous blood purification treatment,the control group of heparin in patients with an initial dose of1000u,continuous500u/h constant patients in the observation group;the first dose of heparin1000u,initial maintenance dose of500u/h,then each4H adjusted once the amount of heparin;compared two groups of patients.Results The observation group treatment time(23.73±18.97)h was significantly higher than the control group(16.28±10.74)h,significant difference(P<0.05).Filter clotting in observation group were significantly less than the control group,there was statistical significance(P<0.05).Compared with the experimental group,there were more cases of blood coagulation in the control group after treatment,the difference between the two groups was significant(P<0.05),the average time of puncture point compression was not significant,and there was no statistical significance.It showed that the anticoagulant effect of the experimental group was better than that of the control group.Conclusion Adjusting the dose of unfractionated heparin in continuous blood purification can prolong the treatment time,improve the treatment effect and prolong the life of filter,which has higher application value.