不同采血方法在持续静静脉血液滤过时对检验结果的影响

目的 探讨在持续静静脉血液滤过（continue veno-venous hemofiltration,CVVH）时,以来自血滤管路的深静脉血替代外周静脉血行血常规、凝血三项及生化检验的可行性。方法 随机选择血液滤过治疗的患者30例,对照组自外周静脉采集血标本,研究组自血滤管路动脉端（静脉血）采集血标本,比较两组的血常规、凝血三项及生化指标是否存在统计学差异。结果 血常规各项结果无统计学差异（P〉0.05）;凝血三项均存在统计学差异（其中2项P〈0.01,1项P〈0.05）,且研究组各项凝血时间均明显长于对照组;生化指标中尿素氮、肌酐、葡萄糖、钙存在统计学差异（其中3项P〈0.05,1项P〈0.01）。结论 CVVH时血滤管路动脉端采血对凝血功能结果和对部分生化指标结果有影响,对血常规结果无影响;因此,临床上可采集血滤管路的深静脉血替代外周静脉血行血常规检验,而不能用作凝血三项及完全替代生化检验。

Influence of Different Blood Sample Collecting Methods during Continue Veno-venous Hemofiltration on Examination Results

Objective To study the feasibility of using blood specimens collected during continue veno venous hemofiltration to replace peripheral blood samples for blood routine,three coagulation markers and Bio-chemical examination.Methods Thirty patients receiving CVVH were selected randomly and blood specimens were collected from both sites: blood specimens collected from vein was defined as the control group,blood specimens collected from access line during CVVH was defined as the observation group.Specimens of both groups were subjected to blood routine,three coagulation markers and Bio-chemical complete set.Results There was significant difference in Ca2+(P<0.01),blood urea nitrogen,creationine,and glucose(P<0.05) and no significant difference in the rest parameters(P>0.05)of biochemical complete set and blood routine(P>0.05) between the 2 groups.Conclusion Blood sample collected from access line during CVVH dose influence the results of coagulation marker and partialy influences the biochemical results,but dose not influence on the results of blood routine.Blood samples form access line can replace peripheral blood samples for blood routine analysis,but not for coagulation marker and biochemical markers.