吸附法无肝素透析联合盐水冲洗法在血液透析中的应用

目的探讨具有高危出血倾向的血液透析（HD）病人，在无肝素透析时采用不同时间间隔的盐水冲洗以减少透析器及管路的血液凝集的效果和安全性。方法对40例有高危出血倾向的长期HD病人采用无肝素透析，在透析过程中分别予不用盐水冲洗、每1小时或30min用盐水冲洗透析器及管路进行分组，观察透析完成情况以及透析器及管路的凝集情况。结果透析中用盐水冲洗方法完成透析例数显著多于不用盐水冲洗方法，透析器及管路凝血明显减少，透析参数稳定。每30分钟与1h盐水冲洗方法比较无明显差异。结论对HD病人有高危出血倾向时采用无肝素透析联合盐水冲洗可减少透析器及管路的凝血，对于多数病人采用每1h冲洗盐水就能达到安全、有效的无肝素透析。

Application of heparin--free absorption hemodialysis in combination with brine flush in the hemodialysis

Objective To explore the effect and security of brine flush with different intervals for reducing the blood agglutination of dialyzer and tubes among hemodialysis (HD) patients at high-risk of bleeding. Methods 40 HD patients at high risk of bleeding adopted heparin-free HD. The dialyzer and tubes were flushed without brine, and with brine per hour or 30 minutes, hereby divided into three groups. The completion state of HD and the agglutination state of dialyzer and tubes were observed. Results Compared to the method without brine, the cases completing HD were much more, the agglutination states of dialyzer and tubes were obviously reduced, and the indexes of HD were more stable in the methods with brine. There was no obvious difference between the methods of brine flush per hour and per 30 minutes. Conclusions Heparin-free absorption hemodialysis in combination with brine flush can reduce the agglutination of dialyzer and tubes for HD patients when they have the high-risk of bleeding. The brine flush per hour can complete the safe and effective heparin-free hemodialysis for most of patients.