不同封管方法对尿毒症并发脑出血的影响

目的比较两种封管方法对维持性血液透析并发脑出血发生率的影响，从而为临床减少尿毒症并发症提供策略。方法将60例维持性血透并行颈内中心静脉置管的患者随机分组（均n=30），分别采用不同浓度肝素钠溶液封管。A组：纯肝素钠封管（6250U／ml）;B组：稀释肝素液封管（稀释后肝素浓度为2500U／ml），观察时间为3～5月，待使用内瘘为血管通路后观察事件终止，了解其脑出血发生率及导管堵塞率。结果A、B两组患者导管堵塞率比较差异无显著性（P〉0．05），而B组脑出血发生率较A组差异有显著性（P〈0．05）。结论用稀释肝素液封管（2500U／ml）不会增加导管堵塞的发生，但可显著减少尿毒症并发脑出血的发生率。

Effect of Different Sealing Methods on Uremia Complicated with Cerebral Hemorrhage

Objective To compare the effects of two different sealing methods on the occurrence of cerebral hemorrhage in maintenance hemodialysis patients. Methods 60 maintenance hemodialysis patients with internal jugular central vein catheterization were randomly divided into 2 groups： Group A and Group B, 30 in each; heparin sodium solution of different concentration was applied in sealing in patients of the 2 groups respectively： pure heparin sodium solution （6250U/ml） in Group A and diluted heparin sodium solution （2500U/ml） in Group B）; the observation lasted from 3 months to 5 months and stopped when fistula was used as the vascular access; the occurrence of cerebral hemorrhage and the occurrence of catheter blockage. Results There existed no obvious difference between the occurrences of the 2 groups （P〉0.05） while the occurrence of cerebral hemorrhage in Group B was of significant difference from that in Group A （P〈0.05）. Conclusions To seal with the diluted heparin sodium solution （2500U/ml） will not increase the catheter blockage and can greatly decrease the occurrence of cerebral hemorrhage in patients with uremia.