国际医药卫生导报
國際醫藥衛生導報
국제의약위생도보
INTERNATIONAL MEDICINE & HEALTH GUIDANCE NEWS
2012年
11期
1580-1582
,共3页
低分子肝素%盐水%血液灌流%凝血%出血
低分子肝素%鹽水%血液灌流%凝血%齣血
저분자간소%염수%혈액관류%응혈%출혈
Low molecular heparin%Normal saline%Hemoperfusion%Coagulation%Hemorrhage
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±0.83 vs 12.91±0.82)、(15.13±0.82 vs 12.51±0.81)、(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±8.10vs 34.58±2.26)]、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)]均较治疗前延长(P＜0.05)、PLT也减少[(138.12±30.50 vs 168.38±36.68)、(136.78±30.12 vs167.55±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.
目的 探討低分子肝素結閤小劑量鹽水在血液灌流中的抗凝效果及安全性.方法 106例急性農藥中毒患者共血液灌流148例次,隨機分為三組,A組50例次採用低分子肝素結閤小劑量鹽水持續泵前滴註抗凝；B組50例次採用單純低分子肝素抗凝；C組48例次採用普通肝素抗凝.治療中觀察患者齣血及體外循環凝血情況,觀察治療前後凝血酶原時間(PT)、活化部分凝血活酶時間(APTT)、凝血酶時間(TT)、血小闆(PLT)的變化.結果 A、B、C三組治療後PT[( 15.10±0.83 vs 12.91±0.82)、(15.13±0.82 vs 12.51±0.81)、(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±8.10vs 34.58±2.26)]、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)]均較治療前延長(P＜0.05)、PLT也減少[(138.12±30.50 vs 168.38±36.68)、(136.78±30.12 vs167.55±31.6)、(86.60±23.20vs164.55±32.10)](P＜0.05)；但C組比A、B組變化更大(P＜0.05).C組齣血髮生率25％( 12/48),明顯高于A、B組(P＜0.05).B組Ⅰ、Ⅱ級凝血髮生率32％( 16/50),明顯高于其他兩組(P＜0.05).結論 低分子肝素結閤小劑量鹽水在血液灌流時具有抗凝效果好、齣血髮生率低等特點,是一種安全、有效、方便的抗凝方法.
목적 탐토저분자간소결합소제량염수재혈액관류중적항응효과급안전성.방법 106례급성농약중독환자공혈액관류148례차,수궤분위삼조,A조50례차채용저분자간소결합소제량염수지속빙전적주항응；B조50례차채용단순저분자간소항응；C조48례차채용보통간소항응.치료중관찰환자출혈급체외순배응혈정황,관찰치료전후응혈매원시간(PT)、활화부분응혈활매시간(APTT)、응혈매시간(TT)、혈소판(PLT)적변화.결과 A、B、C삼조치료후PT[( 15.10±0.83 vs 12.91±0.82)、(15.13±0.82 vs 12.51±0.81)、(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±8.10vs 34.58±2.26)]、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)]균교치료전연장(P＜0.05)、PLT야감소[(138.12±30.50 vs 168.38±36.68)、(136.78±30.12 vs167.55±31.6)、(86.60±23.20vs164.55±32.10)](P＜0.05)；단C조비A、B조변화경대(P＜0.05).C조출혈발생솔25％( 12/48),명현고우A、B조(P＜0.05).B조Ⅰ、Ⅱ급응혈발생솔32％( 16/50),명현고우기타량조(P＜0.05).결론 저분자간소결합소제량염수재혈액관류시구유항응효과호、출혈발생솔저등특점,시일충안전、유효、방편적항응방법.
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 hemoperfusion were divedid into 3 groups.Group A received continuous anticoagulation with low molecular heparin plus small dose of normal saline; 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 ± 4.40vs.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.
