兩種無肝素血液透析方法的效果比較

Comparison of the outcome of two heparin-free hemodialysis methods

目的比較腎衰竭患者在無肝素血液透析中分別採用生理鹽水間歇沖水法(Intermittent saline flushing,ISF)和持續滴注生理鹽水沖水法(Continuous saline infusion,CSI)的效果。方法經醫生評估,需要無肝素透析≥2週的40例患者採用自身對照的方法,1週無肝素透析用ISF法,後1週無肝素透析用CSI法,比較兩組的療效。結果兩組透析器凝血情況CSI組優於ISF,兩組透析器0~Ⅲ級凝血發生情況比較,其差異有統計學意義(χ^(2)=8.16,P<0.05);兩組護理操作耗時比較,實驗組耗時明顯短於對照組,其差異有統計學意義;透析併發症的發生率比較,其差異無統計學意義(χ^(2)=7.343,P>0.1)。結論本次研究表明,終末期腎衰竭患者應用無肝素透析治療中,CSI法優於ISF法,有助於降低透析器凝血的發生率,提高透析充分性,幫助減輕工作人員的工作量,保證治療過程的順利進行。

Objective To compare the outcome of intermittent saline flushing(ISF)and continuous saline infusion(CSI)in patients with renal failure on heparin-free hemodialysis.Methods According to doctor's assessment,40 patients who needed heparin-free dialysis for≥2 weeks were treated by self-control method,one week without heparin dialysis using ISF method,and the following week without heparin dialysis using CSI method,and the efficacy of the two groups was compared.Results The coagulation of the two groups of dialyzers in the CSI group was better than that of the ISF.The difference in the occurrence of coagulation between the two groups of dialyzers from 0 to III was statistically significant(c2=8.16,P<0.05).Comparison of the time-consuming nursing operations between the two groups,the time-consuming of the CSI group was significantly shorter than that of the ISF group,and the difference was statistically significant;while compared with the incidence of dialysis complications,the difference was not statistically significant(c2=7.343,P>0.1).Conclusion This study shows that the CSI method is better than the ISF method in the treatment of end-stage renal failure patients with heparin-free dialysis,which helps to reduce the incidence of dialyzer coagulation,to improve the adequacy of dialysis and reduce the staff Workload.