| 无肝素抗凝的连续性血液净化疗法对脓毒症患者凝血功能的影响 |
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| 引用本文： | 边双双,张萍,张存海,陈江华.无肝素抗凝的连续性血液净化疗法对脓毒症患者凝血功能的影响[J].浙江医学,2010,32(12):1793-1794,1803. |
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| 作者姓名： | 边双双 张萍 张存海 陈江华 |
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| 作者单位： | [1]浙江大学医学院附属第一医院肾脏病中心,杭州310003 [2]解放军第117医院ICU,杭州310003 |
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| 摘 要： | 目的 观察无肝素抗凝对脓毒症患者的连续性血液净化（CBP）疗法对凝血功能的影响.方法 对46例脓毒症合并有急性肾损伤（AKI）患者行CBP治疗,因患者有活动性出血,采用无肝素抗凝治疗,并观察治疗前、后24、48、72h时患者的凝血酶原时间（PT）、活化的部分凝血活酶时间（APTT）、纤维蛋白原（Fg）、凝血酶时间（TT）及D二聚体（DD）、血小板计数（PLT）的变化.结果 患者治疗后DD和PLT均较治疗前下降,PT较治疗前缩短,APTT和TT较治疗前延长,差异均有统计学意义（均P＜0.05）,治疗前、后Fg水平的差异则均无统计学意义（均P＞0.05）.患者治疗后的出血症状与治疗前比较无明显加重.结论 无肝素抗凝的连续性血液净化治疗对高危出血患者是安全的,且对机体凝血系统有一定的影响.
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| 关 键 词： | 连续性血液净化 无肝素 凝血功能 脓毒症 |
The effect of heparin-free continuous blood purification therapy on blood coagulation in septic patients with hemorrhage |
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| Institution: | BIAN Shuangshuang, ZHANG Ping, ZHANG Cunhai, et al. Kidney Center, the First Affiliated Hospital of Zhejiang University School of Medicine Hangzhou 310003, China |
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| Abstract: | Objective To observe the change of blood coagulation of heparin-free continuous blood purification （CBP） treatment in septic patients with hemorrhage. Methods Forty six patients with sepsis received heparin-free CBP. The prothrombin time （PT）, activated partial thromboplastin time （APTT）, fibrinogen （Fg）, thrombin time （TT）, Ddimer （DD） and platelet count （Pit） were measured before and 24h, 48h, 72h after treatment. Results There were no changes of hemorrhage in patients after treatment. PT decreased dramatically than before treatment; APTT, TT and DD slightly increased; Pit decreases at 48h and 72h compared with before treatment （P 〈0.05）. Conclusion Heparin-free CBP is a safe therapy with little effect on blood coagulation for septic patients with hemorrhage. |
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| Keywords: | Continuous blood purification Heparin free Coagulation Sepsis |
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