摘要
目的探讨适用于Ⅳ度血小板减少患者肝素稀释液静脉留置针封管的最佳浓度。方法选择血液科Ⅳ度血小板减少的患者90例，信封法随机抽签分为A、B、C3组各30例，A组采用6．25U／ml肝素稀释液1ml封管；B组采用12．50U／ml肝素稀释液1ml封管；C组采用25．00U／ml肝素稀释液1ml封管。拔管后观察3组患者血小板计数、血浆凝血酶原时间（胛）、活化部分凝血活酶时间（APTT）、血浆纤维蛋白原（Fbg）的变化，比较导管堵塞发生率及留置时间。结果3组患者置管前及拔管后血小板计数、PT、APTT、Fbg比较差异无统计学意义（P〉0．05）；A组导管堵塞发生率66．7％（20／30），B组导管堵塞发生率43．3％（13／30），C组导管堵塞发生率16．7％（5／30），差异有统计学意义（χ^2=15．000，P〈0．01）；3组患者留置时间≥3d例数均不同，A组占43.3％（13／30），B组占70．0％（21／30），C组占83．3％（25／30），差异有统计学意义（χ^2=11．000，P〈0．01）。结论Ⅳ度血小板减少患者静脉留置针封管采用25．00U／ml肝素稀释液1ml封管安全无风险，可以降低导管堵塞发生率，延长导管使用时间。
Objective To explore the optimal concentration of heparin sodium solution, which to seal up intravenous indwelling needle, in patients with Ⅳ thrombocytopenia. Methods A total of 90 patients with Ⅳ thrombocytopenia who required intravenous indwelling needle were randomly divided into three groups which namely A, B and C groups with 30 cases each. A group was sealed up the tube of intravenous indwelling needle with 1 ml heparin sodium solution of 6.25 U/ml, B group with 12.50 U/ml and C group with 25.00 U/ml. The change of the platelet count, plasma prothrombin time （PT）, activated partial thromboplastin time （APTT）, plasma fibrinogen （Fbg） after extubation were observed in three groups and the incidence of blocking up and retention time were compared among three groups. Results The change of the platelet count, PT, APTF, Fbg were showed no statistical significance among three groups （P 〉 0.05）. The incidence of blocking up was 66.7% （22/30） in A group, 43.3%（13/30） in B group and 16.7% （5/30） in C group. They were showed statistical significance （χ^2=15.000, P 〈 0.01）. Retention time of tube above or equal to 3 days were observed respectively 13 person （43.3%,13/30） in A group, 21 cases（70.0%, 21/30） in B group, 25 patients（83.3%, 25/30） in C group. All above were showed statistical significance （χ^2=11.000, P 〈 0.01）. Conclusions Heparin sodium 25.00 U/ml sealing up the tube of intravenous indwelling needle is safe in patient with Ⅳ thrombocytopenia, which will reduce the ration of blocking tube and extend the life of tube.
出处
《中国实用护理杂志》
2017年第14期1060-1062,共3页
Chinese Journal of Practical Nursing
基金
江西省萍乡市市级科研指导性计划项目（2014NS024）
关键词
Ⅳ度血小板减少
静脉留置针
肝素
封管
Ⅳ thrombocytopenia
Intravenous indwelling needle
Heparin
Sealing up
