术后无肝素血液透析探讨

摘要

目的观察手术后患者无肝素血液透析是否比透析中使用肝素抗凝更加安全。方法将63例外科手术后的血液透析患者随机分为两组。对照组血液透析中使用肝素抗凝，研究组行无肝素血液透析。血液透析治疗过程及治疗后观察透析管路及透析器的凝血程度，在透析结束24 h后检测患者APTT、PLT、HGB，观察手术伤口情况。结果无肝素血液透析较血液透析中使用肝素抗凝加重了患者的血小板减少和贫血程度，在血液透析过程中使用肝素更能保证体外循环的顺畅，并未增加术后伤口出血的风险及凝血功能的异常。结论对于外科手术后的血液透析患者，使用肝素抗凝是安全的，无肝素血液透析带来了更多不良影响。%Objective To investigate whether or not heparin free hemodialysis,is safer than hemodialysis with heparin anticoagulation in postoperative patients. Methods 63 case of hemodialysis patients after surgical operation were randomly divided into the control group and study group,use of heparin in the control group of hemodialysis,study group underwent hemodialysis without heparin.Observed the degree of coagulation within dialysers and pipeline of hemodialysis treatment process and after treatment.At the end of treatment after 24 hours, APTT,PLT and HGB were measured in two groups,surgical wound were observed.Results Heparin free hemodialysis with used of heparin in hemodialysis,increased the degree of thrombocytopenia and anemia.The use of heparin in hemodialysis,extracorporeal circulation can better ensure the smooth and did not increase the risk of postoperative wound bleeding and coagulation abnormalities. Conclusion To the hemodialysis patients after surgical operation,the use of heparin anticoagulation is safe,heparin free hemodialysis cause more adverse reactions.