生理盐水变速预冲方法对透析器凝血的影响

Effect of beforehand flushing method by NS with variable speed on blood coagulation in dialyzer

目的:探讨血液透析中透析管路和透析器的变速及匀速两种生理盐水预冲方法对透析器凝血状况的影响。方法:选取威高血液净化中心收治的40例行维持性透析患者,将所有患者按照不同预冲方法分为匀速预冲组和变速预冲组,每组20例,匀速预冲组和变速预冲组患者分别采用匀速预冲法和变速预冲法对透析管路和透析器进行20次预冲,共计400例次生理盐水预冲。监测患者每次透析后透析器的凝血状况,对两组透析器进行凝血评级,比较凝血评级数据。结果:匀速预冲组分级为0级者318例(占79.5%),Ⅰ级者82例(占20.5%);变速预冲组分级为0级者363例(占90.75%),Ⅰ级者37例(占9.25%)。两组均未出现Ⅱ~Ⅲ级者,患者分级情况比较差异有统计学意义(x^2=19.99,P<0.001)。结论:变速生理盐水预冲方法对维持性血液透析患者透析充分性具有显著的影响,可有效减少护理人员工作量,有效降低凝血状况。

Objective:To investigate the effects of beforehand flushing methods of normal saline(NS) with variable speed and uniform speed of dialysis pipeline and dialyzer for blood coagulation in hemodialysis.Methods:40 patients who underwent maintenance dialysis in Weigao Blood Purification Center were divided into beforehand flushing group with uniform speed(20 cases) and beforehand flushing group with variable speed(20 cases) according to different beforehand flushing methods.The patients of beforehand flushing group with uniform speed adopted uniform speed to implement flushing of 20 times and ones of beforehand flushing group with variable speed adopted variable speed to implement flushing of 20 times for dialysis pipeline and dialyzer,respectively.A total of 400 cases/times NS were used to implement beforehand flushing.And the situations of blood coagulation in dialyzer post each dialysis were monitored,and grading of blood coagulation for dialyzer of two groups were implemented,and the grading data of blood coagulation between the two groups were compared.Results:In beforehand flushing group with uniform speed,318 cases(79.5%) were classified as grade 0 and 82 cases(20.5%) were classified as grade I.While in beforehand flushing group with variable speed,363 cases(90.75%) were classified as grade 0 and 37 cases(9.25%) were classified as grade I.There were no patients with grade II-III in both groups.The difference of grading situation between different groups was significant(x^2=19.99,P<0.001).Conclusion:The beforehand flushing method by NS with variable speed has significant effects on dialysis adequacy of patients who undergo maintenance hemodialysis,and it can effectively reduce workload of nursing staffs and the situation of blood coagulation.