低分子量肝素与普通肝素在血透抗凝中的对比观察

目的观察对比低分子量肝素(LMWH,克赛)和普通肝素(SH)在血液透析(HD)中抗凝的疗效.方法23例伴有出血或出血倾向的急、慢性肾功能衰竭HD患者为LMWH组,应克赛抗凝,在HD前静脉端一次性注射40mg;10例无出血倾向者为SH对照组,采用常规普通肝素抗凝.观察体外循环凝血情况、临床有关征象及HD疗效.结果两组体外循环凝血情况、透析器Curea和Ccr无显著差异(P＞0.05);LMWH组对KPTT的影响较SH组小(P＜0.01).结论LMWH在急、慢性肾功能衰竭伴出血患者HD中应用安全、有效,优于SH.

Comparison of low molecular weight heparin to standard heparin in hemodialysis

Objective: To compare the efficacy and safety of low molecular weight heparin (LMWH, enoxaparin) to standard heparin (SH) in hemodialysis. Methods: 23 cases of hemodialysis patients with bleeding tendency were given a single predialysis bolus injection of 40 mg enoxaparin as anticoagulant in comparison with SH administered with a routine infusion in 10 cases of stable hemodialysis patients. Thrombus formation in the extracorporeal circuit, KPTT, and dialyzer clearance of urea, creathinine were observed. Results: significant increase (P<0.01) was seen in KPTT in SH group compared with LMWH group; there was not significant difference in thrombus formation in the extracorporeal circuit and dialyzer cleaeance of urea, creatinine (P>0.05) in the two groups. Thrombus formation in the extracorporeal circuit was minial in 78.9% dialysis sessions, but 3.5% was serious in LMWH group. 3 cases was complicated mild bleeding in central venous catheter sites in LMWH group. Conclusion: A single predialysis bolus injection of LMWH (enoxaparin) gives safe and effective anticoagulation in hemodialysis patients.