摘要
目的探究血液透析患者使用不同抗凝药物治疗后凝血指标变化情况及出血发生状况。方法选取2017年6月—2018年6月于泰州市中西医结合医院肾内科行血液透析的80例患者,按照随机数字表法分为两组,每组40例。对照组在透析前给予静脉注射低分子肝素钙,观察组患者则给予依诺肝素钠;对比两组凝血指标变化、出血及凝血发生率。结果两组治疗前凝血各指标比较,差异无统计学意义(P>0.05);观察组血小板表面α颗粒膜蛋白(GMF-140)为(23.59±3.45)pmol/L、凝血酶原片段1+2(PF1+2)为(124.76±28.53)pmol/L、凝血速度(CR)为(18.42±3.26)sig/min、凝血时间(gbACT)为(162.53±20.14)s、血小板功能(PF)为(1.82±1.03),均低于对照组(28.74±3.61)pmol/L、(286.75±28.64)pmol/L、(23.58±3.72)sig/min、(178.92±23.48)s、(2.46±1.52),差异有统计学意义(t=6.523、25.343、6.598、3.351、2.205,P<0.05);观察组出血率为0.00%,凝血发生率为2.50%,均低于对照组15.00%、20.00%,差异有统计学意义(χ~2=4.505、4.507,P<0.05)。结论血液透析患者给予依诺肝素钠治疗有助于降低凝血指标,减少出血及凝血发生率,值得临床推广应用。
Objective To investigate the changes of coagulation parameters and the occurrence of hemorrhage in hemodialysis patients treated with different anticoagulant drugs. Methods 80 patients who underwent hemodialysis in the Department of Nephrology, Taizhou City Hospital of Integrated Traditional Chinese and Western Medicine from June 2017 to June 2018 were enrolled in the study. The patients were divided into two groups according to the random number table, 40 cases in each group. The control group was given intravenous low-molecular-weight heparin calcium before dialysis, and the observation group was given enoxaparin sodium;the coagulation index changes, bleeding and coagulation rate were compared between the two groups. Results There were no significant differences in the pre-treatment coagulation parameters between the two groups(P>0.05). The α-membrane protein(GMF-140) on the platelet surface of the observation group was(23.59±3.45)pmol/L, prothrombin fragment 1+ 2(PF1+2) was(124.76±28.53)pmol/L,coagulation rate(CR) was(18.42±3.26)sig/min, clotting time(gbACT) was(162.53±20.14) s, and platelet function(PF)was(1.82 ±1.03), both lower than the control group(28.74 ±3.61)pmol/L,(286.75 ±28.64)pmol/L,(23.58 ±3.72) sig/min,(178.92±23.48)s,(2.46±1.52), the difference was statistically significant(t=6.523, 25.343, 6.598, 3.351, 2.205, P<0.05);the bleeding rate of the observation group was 0.00%, and the coagulation rate was 2.50%, which was lower than the control group 15.00%, 20.00%, the difference Statistically significant(χ^2=4.505, 4.507, P<0.05). Conclusion Heparin sodium treatment in hemodialysis patients can help reduce blood coagulation index and reduce the incidence of bleeding and coagulation. It is worthy of clinical application.
作者
冯杨梅
邵振华
黄泽民
FENG Yang-mei;SHAO Zhen-hua;HUANG Ze-min(Department of Nephrology, Taizhou Hospital of Integrated Traditional Chinese and Western Medicine, Taizhou, Jiangsu Province, 225300 China)
出处
《系统医学》
2019年第3期65-67,共3页
Systems Medicine
关键词
血液透析
依诺肝素钠
低分子肝素钙
凝血指标
出血状况
Hemodialysis
Enoxaparin sodium
Low molecular weight heparin calcium
Coagulation index
Bleeding condition
