无肝素透析联机清除率监测的临床应用

The clinical application of clearance monitor by no heparin hemodialysis

目的 探讨无肝素透析联机清除率监测的临床应用以及疗效。方法 先用肝素盐水预充管道 ,接管后丢弃肝素盐水 ,透析过程中每 1 5～ 30min用生理盐水 1 5 0～ 2 0 0ml快速冲洗透析器和管路。观察对患者出血、体外循环凝血、Kt/V值的影响。结果 1 2例急慢肾功能衰竭合并高危出血患者共行 5 8例次无肝素透析 ,未见出血加重 ,但部分患者因凝血 ,透析时间缩短 ,透析效率下降。结论 无肝素透析安全简便 ,适用于高危出血患者 ,但部分患者透析效率下降 。

OBJECTIVE To discuss the clinical application of clearance monitor by no heparin hemodialysis. METHODS First, filled the line with physiological saline contained heparin. Then connected the line and emptied the physiological saline. Washed the dialyzer and line with 150～200 ml PS per 15～30 minutes during the course of hemodialysis. Observed the effect to the patient of hemorrhage, coagulation and the level of Kt/V. RESULTS There were 58 cases of the 12 patients who were acute or chronic renal failure with serious danger of hemorrhage. We did not find more serious hemorrhage. But some patients' time of hemodialysis was shorter and the effect of hemodialysis was declined because of coagulation. CONCLUSIONS Hemodialysis without heparin was safe and easy for the patients with serious danger of hemorrhage. But some patients whose effect of hemodialysis was declined need increase the times of hemodialysis.