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目的回顾性研究单步经皮旋转气管切开术在持续性床旁血液滤过(CBP)全身性肝素抗凝患者中的临床应用效果,并评价其在临床应用中的安全性。方法对黑龙江省医院重症医学科2009年1月1日-2012年3月1日行单步经皮旋转气管切开术的40例病例进行回顾性比较分析,其中实验组20例患者同时行持续性床旁血液滤过全身性肝素抗凝治疗,对照组为凝血机制正常患者20例。观察两组患者24 h内总出血量在20 ml以内及20 ml以上例数的不同,比较两组患者24 h内出血量在20 ml以上的大出血率。结果与凝血机制正常患者相比,同时行持续性床旁血液滤过全身性肝素抗凝治疗中的患者行单步经皮旋转气管切开术的24 h内出血量在20 ml以上的大出血率差异无统计学意义。结论单步经皮旋转气管切开术在持续性床旁血液滤过全身性肝素抗凝治疗的患者中应用是相对安全的。
Objective To retrospectively study the clinical effect of single-step percutaneous transhepatic tracheostomy in patients with continuous placebo hemofiltration (CBP) in patients with systemic heparin anticoagulation and evaluate its safety in clinical application. Methods A retrospective analysis was performed on 40 cases of single-stage percutaneous transthmatic tracheotomy performed in Department of Critical Care Medicine of Heilongjiang Provincial Hospital from January 1, 2009 to March 1, 2012. Twenty patients in the experimental group continued at the same time Sexual bedside hemofiltration of systemic heparin anticoagulant therapy, the control group of patients with normal coagulation mechanism in 20 cases. The total amount of bleeding within 24 hours and the number of cases of more than 20 ml within 24 hours were observed. The rates of major bleeding in more than 20 ml were compared between two groups within 24 hours. Results Compared with patients with normal coagulation mechanism, the rate of bleeding in patients who underwent continuous bedside hemofiltration in patients with systemic heparin anticoagulation at a mean time of more than 20 ml No statistical significance. Conclusions Single-stage percutaneous transhepatic tracheostomy is relatively safe for use in patients undergoing continuous-bed hemofiltration of systemic heparin anticoagulation.