摘要
目的观察低分子肝素用于血液透析与血液灌流联合治疗的临床疗效。方法维持性血液透析患者25例(其中男性14例、女性11例,平均年龄62.3岁)接受血液透析与血液灌流联合治疗。应用低分子肝素(速碧林)抗凝,干体质量小于40kg者于治疗开始时一次性静注0.4ml;干体质量40～60kg者于治疗开始时一次性静注0.4ml,治疗1h后追加肝素8mg;干体质量大于60kg者于治疗开始时一次性静注0.4ml,治疗1h后追加肝素12mg。结果血液透析与血液灌流联合治疗352例次,灌流器凝血发生率为0.28%,透析器凝血发生率为3.69%。动静脉内瘘患者共治疗260例次,透析器凝血发生率为3.08%;中心静脉插管患者共治疗92例次,透析器凝血发生率为5.43%。透析后压迫止血时间为(11±5)min,无1例患者治疗后诱发出血。结论本文将低分子肝素应用于血液透析与血液灌流联合治疗并对抗凝剂的具体用量进行了量化分组,取得了较好的效果,为临床上血液透析与血液灌流联合治疗时抗凝剂的用量提供了一种方法。
Objective To investigate the clinical effects of LMWH in combination treatment of Hemodialysis-Hemoperfusion.Methods Twenty-five ESRD patients（14M,11F;mean age：62.3yr） getting combination treatment of hemodialysis-hemoperfusion were included.The dose of heparin was adjusted according to dry weight.Dry weigh 40 kg：a single bolus of Fraxiparine 0.4ml iv.at the beginning of treatment;dry weight between 40 and 60 kg：a bolus of Fraxiparine 0.4ml iv,an additional regimen of heparin 8mg was administrated 1 hour after the treatment;dry weigh 60 kg：a bolus of Fraxiparine 0.4ml iv,additional regimen of heparin 12mg was administered 1 hour after the treatment.Results Total 352 times of the combination treatment of hemodialysis-hemoperfusion,the incidence of thrombus in resin hemoperfusion cartridge was 0.28%,in dialyser was 3.69%.Patients with arteriovenous fistula received 260 sessions,those with central venous catheter received 92 sessions,the incidence of thrombus in dialyser is 3.08% and 5.43% respectively.Hemostasis time was 11.3±5.21 minutes,and no treatment induced bleeding.Conclusions The study has been quantified the usage of anticoagulant in combination treatment of hemodialysis-hemoperfusion and give an alternative option to clinical practice.
出处
《中国血液净化》
2011年第8期455-457,共3页
Chinese Journal of Blood Purification
基金
广东省科技计划项目(2008B030301139)
关键词
血液透析
血液灌流
低分子肝素
Hemodialysis
Hemoperfusion
Low-molecular-weight heparin
