连续性静脉-静脉血液滤过联合低分子肝素钙抗凝在重症脓毒症治疗中的效果观察

Effect Observation of Continuous Veno Venous Hemofiltration Combined with Low Molecular Weight Heparin Calcium Anticoagulation for Severe Sepsis Patients

目的观察并评价低分子肝素钙抗凝药物联合连续性静脉-静脉血液滤过治疗重症脓毒症的效果与影响。方法收集2019年1月-2021年12月在山东省济南市商河县人民医院接受连续性静脉-静脉血液滤过治疗的重症脓毒症患者(共计80例)的临床相关资料,并按照所用抗凝药物的不同将80例患者分为对照组(n=40例)与研究组(n=40例)。在连续性静脉-静脉血液滤过治疗期间,对照组重症脓毒症患者采用肝素钠注射液抗凝,研究组采用低分子肝素钙抗凝。密切观察两组患者治疗前后的凝血功能指标与血小板计数,并比较两组的出血事件发生率、C-反应蛋白水平与降钙素原水平。结果治疗后,所有患者的临床检验指标均有所改善,且研究组明显优于对照组(P<0.05);对比两组出血事件发生率,研究组明显低于对照组(P<0.05)。结论重症脓毒症患者在连续性静脉-静脉血液滤过治疗过程中配合使用低分子肝素钙,有助于改善凝血功能与炎症反应,提高血小板计数水平,预防或减少出血事件,值得在临床中持续应用。

Objective To observe and evaluate effect of different anticoagulants combined with continuous veno venous hemofiltration in treatment of severe sepsis.Methods The paper collected clinical data of 80 cases severe sepsis patients with continuous veno venous hemofiltration treatment in Jinan City Shanghe County People's Hospital from January 2019 to December 2021,and divided them into control group(n=40 cases)and study group(n=40 cases)according to different anticoagulants.During continuous veno venous hemofiltration treatment,severe sepsis patients in control group were anticoagulated with heparin sodium injection,and those in study group with low molecular weight heparin calcium.Blood coagulation function and platelet count was closely observed before and after treatment between two groups,incidence of bleeding events,C-reactive protein level and calcitonin level was compared between two groups.Results After treatment,clinical test indicators of patients were improved,those of study group were significantly better than control group(P<0.05).Incidence of bleeding events in study group were significantly lower than control group(P<0.05).Conclusion Lowmolecular-weight heparin calcium combined with continuous veno venous hemofiltration can improve coagulation function and inflammatory reaction,increase platelet count of severe sepsis patients,prevent or reduce bleeding events,which is worthy of continuous application in clinical practice.