不同封管方法在老年患者的血液透析临时性导管中的应用

目的:不同的封管方法对老年血液透析患者临时导管的应用分析,探讨对老年患者更有效且更安全的封管方法。方法:选择70例从2018年12月~2019年4月在某院以临时性透析导管作为血管通路进行透析的老年患者(年龄>60岁),按随机分组把患者分为枸橼酸钠组与肝素钠组各35例。对比两种封管方法的经济学效益,并观察两组封管效果以及凝血效果。结果:2.5%枸橼酸钠导管封管器的费用相对于使用肝素钠封管可减少17.6%,并且明显减少护士的操作时间。两组患者在导管感染、导管堵塞等不良事件上差异无统计学意义(P>0.05);4mg/ml浓度的肝素封管后APTT显著延长,差异有统计学意义(P<0.05);而2.5%枸橼酸钠封管液封管后不影响老年透析患者的凝血功能,对老年患者更加安全。结论:使用2.5%枸橼酸钠封管器对老年血液透析患者临时导管是安全有效的,并且更加节省成本和操作时间。

Application of Different Sealing Methods in the Temporary Catheter of Hemodialysis in Elderly Patients

Objective:To analyze the application of different sealing methods in the temporary catheters in elderly patients with hemodialysis,and to explore more effective and safer sealing methods for elderly patients.Methods:From December 2018 to April 2019,70 elderly patients(age>60 years)with temporary dialysis catheter as vascular access in a hospital were selected and randomly divided into sodium citrate group and heparin sodium group,with 35 patients in each group.The economic benefits of the two methods were compared,and the sealing effect and coagulation effect of the two groups were observed.Results:The cost of 2.5%sodium citrate catheter sealer reduced by 17.6%compared with that of heparin sodium catheter sealer,and the operation time of nurses was significantly reduced.There was no significant difference in adverse events such as catheter infection and catheter blockage between the two groups(P>0.05).APTT was significantly prolonged after 4 mg/ml heparin tube sealing,and the difference was statistically significant in the two groups(P<0.05).While 2.5%sodium citrate did not affect the coagulation function of elderly dialysis patients,and it was safer for elderly patients.Conclusion:The application of 2.5%sodium citrate sealing de-vice is safe and effective for temporary catheter in elderly hemodialysis patients,which can save more cost and operation time.