摘要
目的:探讨局部枸橼酸抗凝(RCA)与全身低分子肝素抗凝在重症高危出血倾向患者持续静脉-静脉血液滤过(CVVH)中的抗凝效果、治疗效率及安全性。方法:回顾性分析66例有高危出血倾向的进行CVVH的重症患者的资料,随机分为对照组36例和观察组30例,对照组采用低分子肝素抗凝,观察组采用局部枸橼酸抗凝,观察两组抗凝效果、出血情况的差异并总结护理措施。结果:观察组滤器使用寿命较对照组明显延长,因滤器凝血而更换管路的比例明显低于对照组;观察组滤器凝血、静脉壶凝血情况均较对照组少(P<0.05)。结论:RCA-CVVH对于出血风险高的重症患者来说是一种安全、有效的肾脏替代治疗方式,特别是在延长滤器寿命方面具有优势,并且保障CVVH治疗顺利实施。
Objective： To investigate the anticoagulant effect,efficiency and safety of regional citrate anticoagulation（ RCA） and systemic low molecular weight heparin anticoagulation in continuous veno venous hemofiltration（ CVVH） of patients with severe and high-risk bleeding tendency. Methods： Retrospectively analyze the data of 66 patients with severe CVVH who were at high risk of bleeding,randomly divide the control group into 36 cases and the observation group into 30 cases. The control group was treated with low molecular weight heparin,the observation group was treated with RCA,the difference of anticoagulant effect and bleeding situation was observed and nursing measures were summarized. Results： The service life of the filter in the observation group was significantly longer than that in the control group,and the proportion of pipeline replacement due to coagulation was significantly lower than that in the control group. The coagulation of the filter and the venous chamber in the observation group were less than those in the control group（ P 〈 0. 05）.Conclusion： RCA-CVVH was a safe and effective renal replacement therapy for critically ill patients with high risk of bleeding,especially in prolonging the life of the filter and ensuring the smooth implementation of CVVH treatment.
出处
《护理实践与研究》
2017年第24期17-19,共3页
Nursing Practice and Research
基金
广东省医学科学技术研究基金项目(A2017422)
关键词
抗凝
肾脏替代治疗
滤器寿命
护理
Anticoagulation
Renal replacement therapy
Life of the filter
Nursing
