应用不同抗凝剂在血液灌流救治急性中毒患者中的比较

目的:通过在血液灌流(HP)救治急性中毒中应用普通肝素(SH)和低分子肝素(LMWH)抗凝,比较两者作为血液灌流抗凝剂的效果及安全性。方法:选择HP治疗中毒患者62例,随机分为两组,分别采用肝素和低分子肝素抗凝,治疗前及结束后测定活化部分凝血活酶时间(APTT)、凝血酶时间(TT)和血小板计数(PLT),观察患者出血、灌流器和管路凝血情况。结果:灌流器及血管通路凝血发生率:SH组10%,LMWH组1.67%;出血发生率:SH组11.67%,LMWH组3.33%,两组比较差异有统计学意义(P<0.05);SH组治疗后APTT、TT较治疗前明显延长,有明显差异;LMWH组治疗前及后APTT、TT无明显差异;两组HP治疗后SH组较LMWH组APTT、TT明显延长,有明显差异;两组PLT治疗前及治疗后组内、组间比较无明显差异。结论:低分子肝素较普通肝素作为HP治疗急性中毒的抗凝剂,具有抗凝效果好、出血并发症少、使用安全、方便的特点。

Comparison of heparin and low molecular weight heparin used as anticoagulants in hemoperfusion to rescue the acute poisoning patients

Objective To compare the effect and safety of heparin(SH) and low molecular weight heparin(LMWH) when they were used in hemoperfusion(HP)as anticoagulants to rescue the acute poisoning patients.Method 62 acute poisoning cases treated with HP were randomly divided into two groups,using SH and LMWH respectively as anticoagulant.APTT,TT,PLT were assayed before and after HP.At the same time hemorrhage and coagulation in device and pipeline were observed.Results The rate of coagulation in device and pipeline in SH group was 10%,and in LMWH group was 1.67%;Hemorrhage in SH group was 11.67%,and in LMWH group was 3.33%,having statistical difference.APTT,TT prolonged significantly after hemoperfusion in SH group,while in LMWH group had no significant difference;after hemoperfusion APTT,TT in two groups had significant difference.PLT had no significant difference before and after hemoperfusion and between two groups.Conclusion LMWH has better anticoagulating effect and less complications than SH when they are used in hemoperfusion to treat acute poisoning patients.