摘要
目的探讨对采用连续性床旁血液净化的高危出血患者应用同步枸橼酸抗凝的临床价值。方法将2014年12月-2015年12月在我院接受治疗的高危出血患者60例选取为观察分析的对象,并遵循随机性原则将其分为两组,分别命名为对照组与观察组,其中对照组患者予以无肝素生理盐水进行治疗,观察组则予以同步枸橼酸抗凝进行治疗,对比分析两组患者在不同治疗下的各项生理指标（心率、血压、呼吸频率、脉氧饱和度）、APACHEⅡ评分（急性生理与慢性健康评分）以及血滤中各时间点的全血活化凝血（WBACT）、不良反应发生情况（出血事件）等。结果所有患者治疗后的各项生理指标均较治疗前有明显的改善现象,但观察组的各项生理指标：心率（88.20±10.20）次/min、血压（120.10±10.15）mmHg、呼吸频率（20.18±6.30）次/min、脉氧饱和度（94.64±3.45）%均较对照组的心率（110.55±10.40）次/min、血压（100.58±20.56）mmHg、呼吸频率（29.15±8.55）次/min、脉氧饱和度（88.10±6.44）%趋于正常指标,APACHEⅡ评分（20.10±4.20）分低于对照组（27.78±6.22）分,且观察组在血滤中各时间点的WBACT均长于对照组,出血事件的发生率（13.33%）少于对照组（50.00%）,几组比较的指标之间均存在较大的差异性,并均存在统计学意义（P〈0.05）。结论对采用连续性床旁血液净化的高危出血患者应用同步枸橼酸抗凝,可以有效地改善患者的各项生理指标,延长WBACT的时间,减少出血事件发生率,具有较高的安全性,具有临床推广的价值。
Objective To explore the clinical value of bedside continuous blood purification at high risk of bleeding in patients with synchronous citrate anticoagulation. Methods 60 cases of high-risk patients with hemorrhage cured in our hsopital from December 2014 to December 2015 were selected and analyzed, and following the random principle, they were divided into two groups, named control group and observation group respectively. Patients in control group were treated with heparin saline treatment, and patients in observation group were treated with synchronous citrate anticoagulation treatment. The indicators in different treatment under various physiological two groups（heart rate, blood pressure, respiratory rate, pulse oxygen saturation）, APACHE score（acute physiology and chronic health evaluation） at each time point and blood filtration in blood coagulation activation（WBACT）, the occurrence of adverse reactions（bleeding） were comparatively analyzed. Results The physiological indexes of all patients after treatment were improved significantly than before treatment, but the physiological indexes of the observation group： heart rate（88.20±10.20） /min, blood pressure（120.10±10.15） mmHg, respiratory frequency（20.18±6.30） /min, pulse oxygen saturation（94.64±3.45）% compared with control group, the heart rate（110.55±10.40） /min, blood pressure（100.58±20.56） mmHg, respiratory frequency（29.15±8.55） /min, pulse oxygen saturation（88.10±6.44）% normal index, APACHE score（20.10±4.20） lower than that of control group（27.78±6.22）, and the observation group at all time points the blood filter of the WBACT were longer than the control group, the incidence of bleeding events（13.33%） than in the control group（50.00%）, there were great differences between several groups of comparative indicators, and there were the statistical significance（P〈0.05）. Conclusion The continuous bedside blood purification of high-risk bleeding in patients with synchronous citrate anticoagulation can improve the physiological indexes of patients effectively, prolong the time of WBACT, and reduce the incidence of bleeding events. It has high safety, and it is worthy of clinical promotion.
出处
《中国医药科学》
2016年第23期211-213,210,共4页
China Medicine And Pharmacy
关键词
高危出血
同步枸橼酸抗凝
连续性床旁血液净化
临床价值
High-risk bleeding
Concurrent citrate anticoagulation
Continuous bedside blood purification
Clinical value
