血液灌流后出血和血小板减少的相关因素分析及对策

目的　探讨血液灌流 (HP)治疗后出血和血小板减少的原因。方法　对 36例 5 5次HP治疗后血小板下降与出血的关系和血小板减少的有关因素进行分析。结果　HP治疗后出血 11例次 (11/ 5 5 ) ,其中 9例次 (9/ 11)血小板数目较治疗前严重减少 (P<0 .0 1)。使用YT— 15 0型灌流器所致血小板的下降比YT—HP— 16 0型灌流器更显著 (P <0 .0 1) ;灌流治疗持续时间在 1小时者血小板下降比治疗 2小时以上者更严重 (P <0 .0 1) ;使用高浓度肝素盐水 (5 0mg/ 5 0 0ml)预灌灌流器比低浓度肝素盐水 (15mg/ 5 0 0ml)血小板减少的程度更显著。结论　血液灌流后出血与血小板下降有关。而血小板的下降与使用灌流器的类型、灌流持续时间和使用肝素的量有关。

Analysis of related factors of bleeding and the platelet descend after the treatment of hemoperfusion

Objective To explore the reasons of bleeding and the platelet reduce after the treatment of hemoperfusion.Methods To analysis the reasons of bleeding and the platelet descend and the related factors of platelet reduce after the treatment of hemoperfusion of 36 cases(55times).Results Bleeding happened in 11 times(11/55) and the numbers of platelet reduce obviously in 9times(9/11)(P<0.01). The degree of platelet descend is more in using the Charcoal kidney types of YT-150 than types of YT-HP-160(P<0.01); more in treatment time keeping on 1 hour than 2 hours(P<0.01); more in the density of 50mg/500ml heparin/brine than in 15mg/500ml.Conclusion Bleeding after the treatment of hemoperfusion has something to do with the platelet descend. But the descend of platelet has something to do with the types of Charcoal kidney and the treatment time keeping on and the density of heparin/brine.