摘要
目的探讨低分子肝素结合小剂量盐水在血液灌流中的抗凝效果及安全性。方法106例急性农药中毒患者共血液灌流148例次，随机分为三组，A组50例次采用低分子肝素结合小剂量盐水持续泵前滴注抗凝；B组50例次采用单纯低分子肝素抗凝；C组48例次采用普通肝素抗凝。治疗中观察患者出血及体外循环凝血情况，观察治疗前后凝血酶原时间（PT）、活化部分凝血活酶时间（APTT）、凝血酶时间（TT）、血小板（PLT）的变化。结果A、B、C三组治疗后PT[（15．10±0．83vs12．91±0．82）、（15．13±0．82vs12．51±0．81）、（20．11±1．78VS12．41±0．80）1、Aerr[（48．15±4．40VS37．59±2．86）、（46．53±4．12VS36．96±2．34）、（78．35±8．10VS34．58±2．26）]、TT[（28．30±1．90vs13．08±0．58）、（26．78±1．76VS13．20±0．60）、（55．69±3．94VS13．06±0．54）]均较治疗前延长（P〈0．05）、PLT也减少[（138．12±30．50VS168．38±36．68）、（136．78±30．12VS167．55±31．6）、（86．60±23．20VS164．55±32．10）]P〈0．05）；但C组比A、B组变化更大（P〈0．05）。C组出血发生率25％（12／48），明显高于A、B组（P〈0．05）。B组I、Ⅱ级凝血发生率32％（16／50），明显高于其他两组（P〈0．05）。结论低分子肝素结合小剂量盐水在血液灌流时具有抗凝效果好、出血发生率低等特点，是一种安全、有效、方便的抗凝方法。
Objective To explore the anticoagulant effect and safety of low molecular heparin combined with low dose of normal saline in hemoperfusion. Methods 106 patients with acute pesticide poisoning who received hemoperfnsion were divedid into 3 groups. Group A received continuous anticoagulation with low molecular heparin plus small dose of normal salin± group B received low molecular heparin alone; and group C received normal heparin for anticoagulation. During treatment, incidence of hemorrhage and extracorporeal circulation coagulation was observed during treatment. Changes in PT, APTT, TT, and PLT were observed after treatment. Results After treatment, PT [（ 15.10 ± 0.83 vs. 12.91 ± 0.82）, （ 15.13 ± 0.82 vs. 12.51 ± 0.81）, and （20.11 ± 1.78 vs. 12.41 ± 0.80）], APTT [（ 48.15 ± 4.40 vs. 37.59 ± 2.86 ）, （ 46.53 ± 4.12 vs. 36.96 ± 2.34 ）, （ 78.35 ± 8.10 vs. 34.58 ± 2.26 ）], and TT [（ 28.30 ± 1.90 vs. 13.08 ± 0.58 ）, （ 26.78 ± 1.76 vs. 13.20 ± 0.60 ）, （ 55.69 ± 3.94 vs. 13.06 ± 0.54 ）] were longer than the baselines （ P〈 0.05 ）, while PLT [（ 138.12 ± 30.50 vs. 168,38 ± 36.68 ）, （ 136.78 ± 30.12 vs. 167.55 ± 31.6 ）, and （ 86.60± 23.20 vs. 164.55 ± 32.10 ）] was fewer （ P〈 0.05 ）. The changes in PT, APTT, TT, and PLT were greater in group C than in groups A and B. The incidence rate of hemorrhage was 25% in group C, which was obviously higher than that in groups A and B （ P 〈 0.05 ）. Conclusions Low molecular heparin combined with low dose of normal saline during hemoperfusion has a good anticoagulant effect and a lower incidence rate of hemorrhage. It is a safe, effective, and convenient anticoagulant therapy.
出处
《国际医药卫生导报》
2012年第11期1580-1582,共3页
International Medicine and Health Guidance News
关键词
低分子肝素
盐水
血液灌流
凝血
出血
Low molecular heparin
Normal saline
Hemoperfusion
Coagulation
Hemorrhage
