摘要
目的探讨活化凝血时间(ACT)标准化监测流程在体外膜肺氧合(ECMO)患者肝素抗凝中的应用价值。方法回顾性分析2019年1月至2020年12月赣州市人民医院重症监护病房行ECMO治疗的46例患者的临床资料,按照治疗方法的不同分为研究组(30例)和对照组(16例)。两组患者在ECMO过程中给予肝素抗凝,对照组采用常规的ACT监测方法,研究组在对照组的基础上采用ACT标准化监测流程。比较两组患者膜肺使用寿命,成功撤机率,3个月内生存率,膜肺、泵及管路凝血程度,不良出血程度。结果研究组膜肺使用寿命长于对照组,成功撤机率及3个月内生存率高于对照组,差异有统计学意义(P<0.05);研究组膜肺、泵及管路凝血程度优于对照组,差异有统计学意义(P<0.05);研究组不良出血程度优于对照组,差异有统计学意义(P<0.05)。结论ACT标准化监测流程应用于ECMO患者能使肝素达到最佳抗凝状态,改善其凝血程度,减少出血不良情况的发生,从而有效提高患者成功撤机率、3个月内生存率,具有较高的临床应用价值。
Objective To explore the application value of the standardized monitoring process of activated coagulation time(ACT)in heparin anticoagulation in patients with extracorporeal membrane oxygenation(ECMO).Methods A total of 46 patients who underwent ECMO treatment in the intensive care unit of our hospital from January 2019 to December 2020 were selected,according to different treatment methods,they were divided into study group(30 cases)and control group(16 cases).The two groups of patients were given heparin during the ECMO process.The control group used the conventional ACT monitoring method,and the study group used the ACT standardized monitoring process on the basis of the control group.The service life of the membrane lung,the probability of successful withdrawal,the survival rate within 3 months,the degree of coagulation of the membrane lung,pump and pipeline,and the degree of unfavorable bleeding between the two groups of patients were compared.Results The service life of the membrane lung in the study group was longer than that in the control group,and the successful weaning rate and survival rate within 3 months were higher than those in the control group,the differences were statistically significant(P<0.05).The degree of coagulation of the membrane lung,pump and pipeline in the study group were better than those of the control group,the differences were statistically significant(P<0.05).The degree of bleeding in the study group was better than that of the control group,and the difference was statistically significant(P<0.05).Conclusion The application of ACT standardized monitoring process to ECMO patients can make heparin achieve the best anticoagulation state,improve the degree of blood coagulation,reduce the occurrence of adverse bleeding,there by effectively increasing the patient′s successful withdrawal rate and survival rate within 3 months,it has a high clinical application value.
作者
魏玲
WEI Ling(Department of Nursing,Ganzhou People′s Hospital,Jiangxi Province,Ganzhou341000,China)
出处
《中国当代医药》
CAS
2021年第35期47-49,53,共4页
China Modern Medicine
基金
江西省赣州市指导性科技计划项目(GZ2019ZSF 381)。
关键词
活化凝血时间
标准化
体外膜肺氧合
肝素
抗凝
Activated clotting time
Standardization
Extracorporeal membrane oxygenation
Heparin
Anticoagulation
