两种在线预冲方法对血液透析滤过凝血的影响

目的探讨两种在线预冲方法对血液透析滤过凝血的影响。方法对既往行血液透析滤过治疗发生凝血的20例患者分别采用传统法和改良法两种在线预冲方法各治疗200例次,比较治疗中各治疗参数和压力指标以及治疗后滤器凝血情况。结果改良法凝血等级低于传统法(P0.01);改良法置换液总量多于传统法(P0.01),跨膜压和静脉压值低于传统法(P0.01)。结论在不增加抗凝剂用量的情况下,改良法可充分湿化滤器;肝素钠在预冲中适量合理使用,可以保证治疗安全,并减少凝血发生。

Influences of two on-line piercing methods on blood clotting of hemodiafiltration

Objective To explore the influences of two on line piercing methods on blood clotting of hemodiafiltration （HDF）. Methods Twenty cases with blood clotting of HDF ever were treated with improved and traditional on line piercing methods separately, each of them were implemented 200 times. The treatment parameters, pressure values in treatment and filter clotting after treatment were compared. Results The level of blood coagulation in improved group was lower than that of the control group（ P 〈 0.01 ）. Values of transmembrane pressure and venous pressure of improved method were lower than those of tradi tional method （ P 〈 0.01 ）, while total replacement volume of improved method was more than that of traditional method （ P 〈 0.01 ）. Conclusion The improved method can fully wet filter in the condition of without increasing anticoagulant dosage. Reasonable use of heparin sodium during on line piercing can ensure treatment safety, and reduce blood clotting.