【摘要】 肾衰竭并高危出血患者进行无肝素透析最关键是预防体外循环凝血。临床上针对影响体外循环凝血的相关因素展开了多种预冲方法的研究,其中传统的无肝素透析用生理盐水预冲在体外抗凝效果得到认可。随着预冲方法不断改进,密闭式循环预冲高通量透析器主要是使用肝素生理盐水密闭循环预冲透析器及管路,肝素充分吸附透析膜及管路。体外循环肝素化,可有效降低患者体外循环凝血,透析过程无需生理盐水冲洗透析器及管路,既可以减轻患者的血容量负荷,又能够减少护士工作量,提高护理质量及透析效果。本文将近年来国内外无肝素透析治疗肾衰竭并高危出血患者预冲方法作一综述。更多还原

【Abstract】 Prevention of cardiopulmonary bypass(CPB) coagulation is the key to Heparin-free dialysis in patients with renal failure and high-risk bleeding. A variety of preflushing methods have been carried out to study the factors affecting coagulation during the CPB, in which the anticoagulant effect of traditional Heparin-free dialysis with physiological saline preflushing in vitro has been recognized. With the continuous improvement of preflushing method,Heparin physiological saline is mainly used in the closed circulation preflushing high flux dialyzer to close circulation preflushing dialyzer and tube, so that Heparin fully adsorbs dialysis membrane and tube. Heparinization during CPB can effectively reduce extracorporeal circulation coagulation and the dialysis process does not need normal saline to flush dialyzer and tube. It can not only reduce the blood volume load of patients, but also reduce the workload of nurses and improve the quality of nursing care and the effect of dialysis. The methods of Heparin-free dialysis in the treatment of renal failure with high risk bleeding in recent years are reviewed as follows.更多还原