【摘要】 目的探讨体外局部肝素抗凝在高危出血倾向患者连续性血液净化(CBP)中的抗凝效果及安全性。方法对30例具高危出血倾向的危重病患者行CBP治疗77例次,均采用体外局部肝素抗凝。观察抗凝效果、出血情况及治疗前后患者凝血参数、血小板计数的变化。结果本组患者滤器使用平均时间为20.7±5.6h。CBP治疗12h体外循环凝血情况:0级69例次(89.6%),Ⅰ级6例次(7.8%),Ⅱ~Ⅲ级2例次(2.6%),抗凝效果比较理想。治疗前后凝血参数、血小板计数差异无显著性(>0.05),无严重出血并发症的发生。结论对伴高危出血倾向的危重病患者行CBP治疗时,体外局部肝素抗凝的抗凝效果较好,能满足CBP的抗凝要求,不增加严重出血的危险性。更多还原

【Abstract】 Objective To study the effect and safety of the regional heparin anticoagulation in continuous blood purification (CBP) in patients with high risk of bleeding. MethodsCBP was administered to 30 critical patients with high risk of bleeding with a total treatment of 77 times. In each treatment, the effectiveness of anticoagulation and the severity of bleeding were observed; variations in the patient’s blood coagulant index and platelets counting before and after treatment were recorded.Results In terms of the effectiveness of anticoagulation, the average duration of dialyzer application was 20.7±5.6 h. In terms of dialyzer coagulation in the 12 h CBP treatments, 69 cases of Grade 0 were found, which accounted for 89.6% of the total; 6 cases of Grade I were found, accounting for 7.8% of the total; and 2 cases of Grade II to Grade III were found, making up the remaining 2.6%. There were no significant variations in patients’ blood coagulant index and platelets before and after treatment (P>0.05). No severe bleeding complications were found.Conclusion While CBP is applied to critical patients with high risk of bleeding, the regional heparin anticoagulant treatment is effective, which satisfies the anticoagulant requirement of CBP without increasing the danger of severe bleeding.更多还原