无肝素预冲对血液透析患者透析充分性的影响

目的 探讨无肝素预冲对维持性血液透析患者透析充分性的影响.方法 50例维持性血液透析患者,采用自身对照,分别用肝素生理盐水(肝素组)和单纯生理盐水(生理盐水组)进行预冲,通过在线尿素清除率的监测测定每次透析的尿素清除指数,同时观察透析器和血液透析管路的凝血情况.结果 肝素组和生理盐水组血液透析后透析器均无凝血现象,虽然管路的动脉壶和静脉壶有微量凝血,但无差异.结论 单纯采用生理盐水进行预冲,不但能保证血液透析充分性,而且可以降低交叉感染的风险、减少肝素用量、简化操作流程,值得推广.

Abstract：

Objective To investigate the effect of pre - washing without heparin on adequacy of hemodialysis. Methods Using self-control method, fifty hemodialysis patients received pre-washing with heparin in normal saline and normal saline. Then we tested Kt/v by online clearance monitoring and observed clotting condition of dialyzer and hemodialysis tubes. Results There were no difference of Kt/v between two methods. After hemodialysis, no clotting phenomenon was found in dialyzer. There was a little pot of coagulation in artery and vein pot, but no significant difference between two methods. Conclusions Pre-washing with normal saline alone can not only ensure the adequacy of hemodialysis, but also reduce the risk of cross infection and reduce the amount of heparin, simplify operational procedures, so it should be promoted.

Effect of pre-washing without heparin on dialysis adequacy in patients with hemodialysis

Objective To investigate the effect of pre - washing without heparin on adequacy of hemodialysis. Methods Using self-control method, fifty hemodialysis patients received pre-washing with heparin in normal saline and normal saline. Then we tested Kt/v by online clearance monitoring and observed clotting condition of dialyzer and hemodialysis tubes. Results There were no difference of Kt/v between two methods. After hemodialysis, no clotting phenomenon was found in dialyzer. There was a little pot of coagulation in artery and vein pot, but no significant difference between two methods. Conclusions Pre-washing with normal saline alone can not only ensure the adequacy of hemodialysis, but also reduce the risk of cross infection and reduce the amount of heparin, simplify operational procedures, so it should be promoted.